Statements & Consultation Responses

2020

Statements

Joint statement on the use of the next European and structural investment funds for strategic investments in health and social services

EUREGHA (European Regional and Local Health Authorities) and EuroHealthNet (The European Partnership of national public health institutes, regional health authorities and related organisations), recognise the pivotal role of cohesion policy as one of the main European investment policies to achieve the EU treaty objective of economic, social, and territorial cohesion.

In the expiring programming period 2014-2020, the European Social Fund (ESF) and the European Regional Development Fund (ERDF) covered substantial health investments; it aimed to improve access to services, develop specialised health infrastructure and capacities to reduce health inequalities, and to boost health and care reforms. With a total of around €9 billion, it demonstrated the substantial contribution of cohesion policy in supporting social and economic convergence across Europe while promoting the health and wellbeing of its citizens. The potential of health and social investments in health and care innovation, public health and reducing health inequalities, however, still demand for significant improvement.

Therefore, in the next programming period 2021-2027, Member States and Regions should aim to allocate improved resources to match needs. This can be achieved through the European Structural and Investments (ESI) funds to ensure, among others, effective investments in health promotion and disease prevention, health care, eHealth and health-enabling services and infrastructures (including Social, economic, cultural and environmental). Moreover, the COVID-19 pandemic is showing the need to step up investments to reinforce health and care system preparedness, responsiveness, and resilience, while ensuring cross-border cooperation across Europe. Solidarity, sustainability, and equity are key to overcome this crisis and its devastating socio-economic consequences. EU Cohesion policy and programmes can contribute with concrete solutions: but significant reforms are needed.

Regions and cities are close to citizens and well placed to understand their health and social needs, challenges, and potential workable solutions. Investments in health and social innovation, public health and social infrastructures must go hand in hand with investments in human capital, skills, and literacy. This integration is best made at levels closest to needs of beneficiaries.

It is therefore of paramount importance to implement holistic regional health strategies built around:

  • New governance: When defining health and care policies at regional levels there should be willingness to overcome silo approaches between health, social, economic, cultural and environmental policies, ensuring the development of more integrated solutions and budgets. This is particularly important in drafting regional operational programmes and ‘smart specialisation’ strategies. To this end Regional Managing Authorities (often regional economic departments) and Health Authorities should improve dialogue and conceive investments that are able to meet citizens unmet health and social needs. A stronger dialogue between departments, policymakers and administrators with relevant responsibilities will potentially improve synergies and alignment of investments among ESI Funds and other relevant EU programmes, such as the new EU Resilience and Recovery Facility (RRF), plus EU4Health, Horizon Europe, InvestEU, Digital and Green Transition funds.
  • Partnerships: For a regional health strategy to be successful, it is important to involve all the relevant territorial stakeholders in structured dialogues, to define unmet needs and how to address them. Patient and public organisations, health, social, and wider public health workforces including educators and trainers, business, and civil society organisations all play a vital role in the health ecosystem and should be included from the outset to delivery, monitoring, and evaluation. When defining the Operational Programmes, it is crucial to consult, share and communicate aims, objectives and priorities in order to engage effective implementation among all potential partners throughout the delivery and investment chains.
  • Better coordination: Cohesion policy should sustain broader institutional reforms within the European Semester process, guided by approaches for a Europe-wide Economy of Wellbeing, the imminent Action Plan for implementation of the European Pillar of Social Rights, and UN Agenda 2030 for Sustainable Development. It is crucial to ensure strong multilevel institutional cooperation to align the ESI Funds Operational Programmes (OPs) and projects for long-term planning policies. Strategic Foresight activities and the urgent innovations and resources of the Recovery and Resilience Facility (RRF) can help steer and implement evidence-based policy making. The Semester cycle should better involve regional, and municipal, and health authorities, so that its recommendations and outcomes become more relevant and coherent with place-based needs and solutions. Fostering an environment of cooperation with local and regional health stakeholders across the EU would help to tackle persistent structural inequalities and build cohesion.
  • A Strategic use of Smart Specialisation Strategies (S3): S3 represent an important instrument for coordinating different policies and funds at the regional level and should be further leveraged at European level through Smart Specialisation Platforms (SSP). The SSP on industrial modernisation include medical technology and personalised medicine as thematic areas. It is strongly recommended though to initiate a new dedicated SSP on Innovative Health and Care Systems Reform. This should work on process innovation and capability of systems to absorb innovative solutions and work with new partnerships across sectors. This Platform could serve as a catalyst to improve the dialogue between relevant policy makers, providers which are often at regional and municipal levels, wider public health workforces and partners (as advocated and defined above). In this context, use of the Interregional Innovation Investment Initiative should be flexible and accessible, to accelerate marketisation and implementation for pan-European value chains.
  • Improving European interregional cooperation across borders and barriers: As a potential European Health Union is being suggested, better strategic use of programmes such as INTERREG can play a part in national border regions throughout Europe. Cross-border health and care improvements can benefit patients by enabling equitable access to health services and infrastructures in other Member States, including diagnosis and clinical trials, based on the principle of “easiest, closest, best and fastest” access. Border regions are naturally at the forefront of this cooperation process, using funds as ERDF. Therefore, to sustain successful initiatives and develop innovations in the COVID-19 recovery contexts, health and care need higher priority in the new ESI programming. Exchanging knowledge and scaling up practices through INTERREG will contribute to reinforcing preparedness and response facilities across borders, which has become a major factor during the pandemic crisis.

Relevant investments should be allocated in the following areas:

  • Health promotion and disease prevention: ESI Funds have made an important contribution to health promotion and disease prevention, supporting programmes that target population level changes, ageing issues, and workplace health and safety. A key factor is multi-sectoral collaboration, essential for interventions addressing social, economic and environmental determinants of health and wellbeing and equity. Clearly now in the pandemic recovery context, health promotion and disease prevention should be included at all levels of policymaking, to overcome silos and link health interventions cohesively across sectors. This will share knowledge and experiences, offer economies of scale and capacity-building, and support public institutions, economic operators and civil society to implement deliverables effectively. Addressing complex risk factors, behavioural shifts and inequalities behind rising non-communicable, chronic, and infectious diseases, requires validated health promotion and disease prevention interventions to be complemented by government policies and programmes in other areas, for example fiscal or consumption measures. Therefore, the effective use of EU funds across sectors, regions and communities for health promotion and prevention is both strategic and practical.
  • Health equity: Demographic and technological changes are increasing pressures on health systems and citizens across the EU. Member State budgets may struggle to adequately cover rising unmet health needs, but universal access to healthcare is a key prerequisite to reduce health inequalities. Human and financial resources are similarly vital to enable access for all to high-quality education, employment and social protection, to prevent disadvantages and promote wellbeing. By increasing or complementing national budgets, cohesion policy and associated EU funds can contribute greatly to improve access to health and social services, enhance quality of life, and improve socioeconomic circumstances of people in both newly defined and existing ‘vulnerable groups’. Such funds are therefore a key tool in tackling health and inequalities. A ‘whole of government and whole of society’ approach across public and private sectors is needed, at all levels from local to international, to achieve truly cohesive, equitable and universal provision of established rights and services and use of relevant funds.
  • Investing in human capital: Investment in people (services, networks, skills, learning, awareness) is crucial for health and social sectors. It is a vital companion for (usually more high-profile) infrastructure projects. In fact, modern health policy thinking advocates a sustainable transition, away from hospital- and institution-based care towards cost-effective prevention and promotion via primary and community methods, which will reduce unsustainable costs of infrastructure expenditures. The European Social Fund, managed at regional levels and working in cooperation with other relevant programmes such as Erasmus+, can play a major role in upskilling and reskilling health and care workforce, in particular digital skills. These include people training and working in those wider sectors which deliver prevention and promotion to achieve meaningful health and social care system transformation. They also bring cohesive societal benefits through improved literacy, life-long learning, employability, work-life balances, social inclusion and active ageing.
  • Social and green infrastructures: While some large-scale infrastructure investment remains necessary to address regional development needs and demographic changes, it is important that it includes the need for a just transition and green infrastructures, including throughout health and care provision. Links between access to health services, social and environmental policies should be strengthened at all levels. Planning and supporting health and social investments within the broader scope of objectives related to social inclusion and sustainability should reinforce the fact that social inclusion and poverty can be strongly impacted by people’s ability to access quality health and care services or facilities. These include housing, safe spaces, transport, and mobility programmes.
  • Health care system transformation: ESI Funds should be allocated to “ensure the transition towards more sustainable, resilient, innovative and high-quality people-centred health and care system” as stated in the European Partnership under Horizon Europe "Transforming health and care systems”. Synergies between Horizon Europe, EU4Health, ERDF and ESF+ are key to ensure cooperation among all relevant stakeholders and accelerate innovation. This shift to a Value-Based Approach, investing in outcomes measurement, collecting data, and improving interoperability among different data systems, will contribute to achieving EU wide objectives of a sustainable and social Recovery, political and Multiannual Financial Framework Objectives, and the UN Agenda (SDG) 2030 targets.

EUREGHA and EuroHealthNet continue to monitor, advise and engage with ongoing EU Institutional negotiations about the next EU long-term budget, and urge the negotiating partners to take into account the recommendations above in implementing programmes and policies. The need to ensure a strong focus on health equity and wellbeing for all have never been more important. This is the time to strengthen investments to reinforce health and care system preparedness, responsiveness, and resilience, through ensuring cross-border and inter-regional cooperation across Europe. Our organisations, members and partners can through this contribute to realising Europe’s ambition for a healthy, fair and sustainable recovery. We have the knowledge and the will to help to achieve these common objectives.

About us:

EuroHealthNet is a not-for-profit partnership of organisations, agencies and statutory bodies working on public health, disease prevention, promoting health, and reducing inequalities. Our Mission is to improve and sustain health between and within European States through action on the social determinants of health, and to tackle health inequalities.

European Regional and Local Health Authorities (EUREGHA) is a Brussels-based network of 17 Regions coming from 10 Countries in Europe. EUREGHA’s mission is to bring regional and local health authorities together as a means to improve health policy in Europe. By doing so, EUREGHA also establishes and promotes collaboration between its members, the institutions of the European Union and with pan European health networks and organisations working with public health and health care.

Statements to the 70th Session of the WHO regional committee for Europe

As a recognised non-state actor, EuroHeatthNet has submitted two statements to the 70th Session of the WHO Regional Committee for Europe.

Prvisional agenda Item 2b: The state of health in the WHO European Region, including lessons learned from the COVID-19 pandemic

The COVID-19 pandemic has painfully exposed health and social inequalities across Europe. EuroHealthNet partners responsible for public health have been at the front line for protection, advice, and delivering timely information since the beginning of the pandemic. We take this opportunity to express gratitude to all colleagues for their tireless efforts. We stand together with WHO Europe and its partners, ready to support a recovery which results not only in stronger health systems, but also in fairer and more resilient societies.  

For many people there is no so-called “new normal” of personal adjustments to which they wish to return. By simply rebuilding we risk preserving the problems of the past. Instead, it is time to create systems and structures which work for everyone, not only the fortunate few. They should effectively face the challenges of tomorrow, whether these are new pandemics or the more ‘chronic emergencies’ like non-communicable diseases, mental ill-health and climate change.  

Growing evidence from the COVID-19 pandemic shows how it has exacerbated and highlighted pre-existing health inequalities1.  

  • Low skilled men have the highest death rate among working age adults2
  • Black people are more likely to die from COVID-19 than white counterparts3.  
  • Most fatalities are amongst those with underlying illnesses such as high blood pressure or diabetes4; while more socially and economically disadvantaged people suffer more from these largely-preventable diseases5.  
  • Migrants, asylum seekers, and Roma people who already experience health inequalities are among the 26% of people in Europe living in overcrowded spaces6. In confinement, women and LGBTI people are more exposed to interpersonal violence.
  • Economic factors such as poverty and unemployment, especially in the context of an austerity policies7 are linked to depression, anxiety and suicide8. People who are unemployed or face financial hardship, families with children, and those with pre-existing mental health problems are all more likely to be vulnerable to these mental health impacts of economic recessions9

The pressures on social protection systems and on health outcomes will be interrelated and complex but vital to address10. They will be felt most strongly by people in insecure or low skilled jobs, and by people from disadvantaged communities experiencing worse housing and living conditions and environmental inequalities11. Young people will be most affected by school closures and face subsequent challenges in seeking employment.  

So, we all need to act. Protecting health is the responsibility of all. Good health starts in communities. We must critically look at how our health systems are structured, their sustainability, and their ability to prevent diseases and protect all, regardless of social status. We all need to act to make recovery fair and health-promoting, leading to a global ‘economy of wellbeing’ and achievement of the Sustainable Development Goals.  

As Member States and International Organisations including WHO Europe seek to balance mitigating the pandemic and ensuring an healthy recovery, we call on all partners to pool knowledge and experience for progress, not return to old ways which failed too many people.  

We know what can work, thanks to numerous resources and evidence from individual countries, as well as WHO Europe work on health equity12. The new evidence from the pandemic has highlighted those needs and solutions, as well as identifying new problems and hopes. It is up to us all to apply that learning for good. 

1 Bergamini, E. (2020). How COVID-19 is laying bare inequality. Bruegel.org. [online] Available at: https://www.bruegel.org/2020/03/how-covid-19is-laying-bare-inequality
2 Wise, J. (2020). Low skilled men have highest death rate of working age adults. BMJ. [online] 369:1906. Available at: https://www.bmj.com/content/369/bmj.m1906
3 Office for National Statistics (2020). Coronavirus (COVID-19) related deaths by ethnic group, England and Wales: 2 March 2020 to 10 April 2020. [online] Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarri... andandwales/2march2020to10april2020  
4 Stuckler, D., Reeves, A., Loopstra, R., Karanikolos, M., McKee, M. (2017). Austerity and health: the impact in the UK and Europe. European Journal of Public Health.[online] 27(4):18-21. Available at: https://academic.oup.com/eurpub/article/27/suppl_4/18/4430523
5 McNamara, C. L., Balaj, M., Thomson, K. H., Eikemeo, T. A., Solheim, E. F., Bambra, C. (2017). The socioeconomic distribution of noncommunicable diseases in Europe: findings from the European Social Survey (2014) special module on the social determinants of health. European Journal of Public Health. 27(1):22-26. 
6 EU-SILC (2018). European Union Statistics on Income and Living Conditions. Available at: https://ec.europa.eu/eurostat/web/microdata/europeanunion-statistics-on-...
7 Bambra C. (2011).  Work, worklessness and the political economy of health inequalities. Journal of Epidemiology and Community Health. 65(9):746–50.
8 Lund C, Brooke-Sumner C, Baingana F, et al.(2018). Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews. The Lancet Psychiatry. 5(4):357–69.
9  Frasquilho D, Matos MG, Salonna F, et al. (2016). Mental health outcomes in times of economic recession: a systematic literature review. BMC Public Health. 16(1):115.
10 Banks J, Karjalainen H, Propper C. (2020). Recessions and health: The long-term health consequences of responses to coronavirus. The Institute for Fiscal Studies. [online] Available at: https://www.ifs.org.uk/uploads/BN281-Recessions-and-health-The-long-term...
11 WHO Europe (2019). Environmental health inequalities in Europe. Second assessment report. Available at: https://apps.who.int/iris/bitstream/handle/10665/325176/9789289054157-en...
12 WHO Europe (2019). The WHO European Health Equity Status Report Initiative. Available at: https://www.euro.who.int/__data/assets/pdf_file/0016/411343/HESRi-case-s...

 

Provisional agenda item 4 The European Programme of Work, 2020–2025 – “United Action for Better Health in Europe”

EuroHealthNet welcomes the draft WHO European Programme of Work (EPW) 2020-2025. The emphasis it gives to the principle of ‘leaving no one behind’ is excellent. Our response focuses on three topics.  

  1. Addressing health inequalities;
  2. The transition to sustainable health systems which are better connected to the factors which influence health outcomes;
  3. Investing in the social side of health crisis preparedness.  

Progress on improving life expectancy and other objective measures of health outcomes have started faltering, even reversing in some cases. Health inequalities were already rising before the COVID-19 pandemic. We need a committed approach at all levels, including political levels, to address health and wellbeing for population groups that experience vulnerability. The concept of vulnerability needs redefining to catch up with changing socio-economic realities. As a partnership of bodies responsible for public health and concerned about growing levels of health inequalities, we need the support from the EPW to encourage ambitious action for health equity and on the related Social, Economic, and Environmental Determinants of health (SEEDs).  

All mechanisms should champion the importance of strengthening health promotion, preventative services, and other public health measures. We need to transform struggling curative systems into health promoting services, which are proactive in meeting emerging challenges and resilient to shocks and crises. Health promotion principles are closely related to behavioural sciences and to embedding healthier choices into health strategies, as also outlined in one of the EPW flagship initiatives. But for many people personal choices are a luxury. We need to create equitable opportunities and enhance the capability of all people and communities to improve health outcomes. The commercial determinants of health which have a harmful influence on behaviours and underlying determinants should also be carefully addressed. 

During the COVID-19 pandemic we have seen a huge mobilisation for funds toward containment and crisis preparedness. This has mainly directed towards health care services and the economy. There is a need to address the acute needs of health professionals and boost hospital capacity. At the same time, financing crisis containment and preparedness through a psycho-social approach that promotes resilience, community and integrated social support have been considered to a lesser extent. This approach should be balanced against reinforcing a predominant bio-medical approach to health. 

We need to build new and better bridges between public health and primary health care, and between the health sector (including mental health), the social sector, and the economy at his whole. We need to incorporate health equity impact assessments in recovery mechanisms and seek to cushion the health impacts of economic and labour market shocks. We need integrated and coordinated cross-cutting political action guided by the UN Sustainable Development Goals, the Health-in-all-Policies-strategy, and the overarching goal of reducing health inequalities1. Improvements are needed in public health workforce competences with regards to skills for health promotion, disease prevention, cross-sector task-shifting, and in digital health literacy. New financing mechanisms must be explored in order to scale up public health work. We are keen to contribute to this area of impact investments through our e-guide on Financing HealthPromoting Services.  

If implemented in accordance with its vision, the Programme can help to address the needs of people along social gradients in the context of fair distribution of assets, power, and resources. We welcome the EPW’s reinforced emphasis on leadership and utilising capabilities of national health authorities – via strategic guidance from WHO Europe in collaboration with relevant international institutions, including at EU level. EuroHealthNet has worked and grown in exactly these fields for over two decades so is ready, willing, and able to help delivery of the EPW to meet these objectives. 

 
1 Siegrist J, Mekel O et al. (2020). Integrated health policy recommendations – Justifying health policy recommendations to mitigate indirect health effects oft he COVID-19 pandemic within public health actions. Bremen: Competence Network Public Health COVID-19, Germany [online] Available at: https://www.public-healthcovid19.de/images/2020/Ergebnisse/Mitigation_en...

EuroHealthNet’s five recommendations for European eHealth priorities

The European Commissions’ eHealth Stakeholder Group supports the Commission in the development of actions for the digital transformation of health and care in the EU. As a member of the group, EuroHealthNet has proposed five priories for the next 12 months.

Digital innovation in health, when developed hand in hand with programmes enhancing health literacy and digital literacy, can have positive effects on the efficiency and sustainability of health systems. It has the potential to improve health outcomes across social gradients.

Our overarching recommendation is to embed Health inequalities and health in all the group’s activities related to the handling of data and development and implementation of digital tools in health.

Our five specific recommendations concern:

Standardising the design of digital tools (‘usability’) to ensure they are safe, comprehensible, easy to use and accessible. The ISO/IEC effectivity and reliability criteria for health and wellness can be considered in developing European standards.

  • Supporting professionals (including through up- and re-skilling) to fully take advantage of new digital health technologies also in their work with lower socio-economic groups. eHealth and digital tools will need to be promoted as part of sustainable local health policies and implemented through community approaches, with local schemes for guidance and support to make them work for everyone.
  • Developing sound digital infrastructures with high quality data that add value to health systems in a non-discriminatory way. This includes ensuring that AI algorithms are designed reflecting the needs, preferences and expectations of vulnerable groups. This also means that people with less digital or health literacy, migrants, people with less education, older people, people with disabilities etc., are adequately included in questionnaires and focus groups as part of the underpinning research.
  • Defining common European standards to overcome the lack of interoperability of data between different health settings and projects. This should include guidelines to ensure issues of data protection, anonymisation and privacy are addressed to avoid harms from private interests, ineptitude or inadequacy.
  • Improving people’s digital health literacy, allowing everybody to not only actively manage their personal health and care, but also to increase their understanding of the quality of apps, their marketing, what their data is being used for and other relevant issues.

Letter to the members of the European Parliament on prioritisation of child poverty reduction in the European Parliament’s Resolution on the Recovery Package and the 2021-2027 EU MFF

Prioritisation of child poverty reduction in the European Parliament’s Resolution on the Recovery Package and the 2021-2027 EU MFF

Dear President Sassoli,

Dear Members of European Parliament,

We are writing to you on behalf of the EU Alliance for Investing in Children[i] to ask for your support in ensuring there is adequate EU budget allocation to the fight against child poverty.

Today, 1 in 4 children in the EU grow up at risk of poverty and social exclusion[ii]. The COVID-19 pandemic and the socio-economic consequences it has already caused and set to put in motion are worryingly expected to escalate this figure exponentially, further affecting health and wellbeing, and the living conditions of millions of people in Europe. 

During the last year, the European Parliament and the European Commission have prioritised child poverty reduction in their proposals for the European Social Fund Plus[iii] calling on every EU Member State to invest 5% of ESF+ resources under shared management to implement measures reducing child poverty.

We are deeply disappointed that despite the European Parliament’s and the European Commission’s proposals, the EU leaders have not earmarked resources to the fight against child poverty under the European Council Conclusions on the EU’s Recovery Package and the EU’s budget for the 2021-2027 EU funding period.

This is a historic moment to champion the rights of children within the EU and ensure that the EU’s Next Generation grows up in inclusive healthy, equitable and prosperous societies.

We therefore encourage you to:

  • Support the mandate adopted by the European Parliament in April 2019 on the European Social Fund Plus[iv], in particular as regards the requirement that every Member State invests at least 5% of ESF+ resources under shared management for tackling child poverty. 
  • Include in the European Parliament’s Resolution on the European Council Conclusions of 21 July 2020 the need to invest in children, to increase the protection of those in vulnerable situations and to eradicate poverty and in particular child poverty via the European Child Guarantee.

With kind regards,

On behalf of the EU Alliance for Investing in Children,

EU Alliance for investing in Children

 

[i] The EU Alliance for Investing in Children has been advocating for a multidimensional, rights-based approach to tackling child poverty and promoting child well-being since 2014.The EU Alliance consists of 22 civil society organisations and Unicef, all working on the issue of child poverty reduction and social inclusion. http://www.alliance4investinginchildren.eu/

[iii] The European Parliament in its proposal on the European Social Fund Plus (onwards ESF+)[iii] took a critical step by proposing that the ESF should be increased by 5,9 billion EUR and “be allocated for measures falling under the European Child Guarantee referred to in Article 10a”,. The European Parliament also proposed that EU “Member States shall allocate at least 5 % of their ESF+ resources under shared management to targeted actions aiming at implementing the European Child Guarantee, in order to contribute to children’s equal access to free healthcare, free education, free childcare, decent housing and adequate nutrition”[iii].

In May 2020, the European Commission updated its proposal on the ESF+[iii] as a response to the social and economic impact of the COVID-19 pandemic.

The European Commission recognised the importance of investing in children and took on board the European Parliament’s ESF+ proposal to tackle child poverty. The European Commission proposed that “EU Member States allocate at least 5% of the ESF+ resources under shared management to support activities addressing child poverty in line with the specific objectives of the ESF+ that allow for programming resources towards actions directly supporting children with regards to early childcare, education, healthcare, decent housing and adequate nutrition”.

Joint Position Paper on a Comprehensive Child Rights Strategy

The EU’s intention to develop a comprehensive Child Rights Strategy represents an important opportunity for the EU to champion the rights of the child within its borders and across the world. 

This position paper presents a set of key principles to guide the Strategy as well as priorities and actions for the European Institutions, Member States, and partner countries to take. The principles and priorities highlighted in this position paper are core principles enshrined in the UN Convention on the Rights of the Child (CRC) and its General Comments. They are also aligned with the UN 2030 Agenda and the 17 Sustainable Development Goals (SDGs).

The recommendations build on the existing EU acquis in the field of child rights, Article 3(3) of the Treaty of the European Union which explicitly recognises the promotion of children’s rights in internal and external affairs as an objective of the EU as well as Article 24 of the EU Charter of Fundamental Rights and the revised European Consensus on Development. They also take into account other EU policy documents, notably the EU Agenda for the Rights of the Child, the European Commission Communication Towards an EU Strategy on the Rights of the Child, the EU Framework of Law for Children’s Rights, the EU Guidelines for the Promotion and the Protection of the Rights of the Child 2017 and its Council Conclusions, and the and European Parliament Resolution on children’s rights on the occasion of the 30th anniversary of the UN Convention on the Rights of the Child.

The priorities we suggest for the strategy are structured around the political guidelines of the 2019-2024 European Commission: an Economy that works for people, Protecting our European way of life, a Stronger Europe in the world, a European Green Deal, a Europe fit for the digital age, a new push for European democracy.

Find the joint position paper here.

Letter to the EPSCO Council: The need for more effective investments and reforms towards sustainable health and care systems

Brussels, 9th June 2020

Dear Ministers of Health and Social Policy,

Dear Health and Social Policy Attaches,

The need for more effective investments and reforms towards sustainable health and care systems

 

In light of the EPSCO meeting today, with this letter EuroHealthNet aims to provide you with further evidence-based information that supports for more ambitious and effective investments and reforms towards sustainable and needs-driven health and care systems. This includes health promotion, disease prevention, and measures tackling health inequalities.[i] Enhancing wellbeing at work and supporting decent working conditions, including addressing in-work poverty and work-life balance are part of the solution. Within this critical moment for each of our countries, there are opportunities. You can help to create more sustainable health systems. You can make sure the recovery from the pandemic and its economic consequences is rapid, efficient, and inclusive by aligning measures towards common goals of sustainability and fairness. These opportunities should not be missed.

The pandemic has revealed profound systematic inequalities in health. This can be seen in exposure to infections, death rates, and co-morbidity with chronic diseases which are highly concentrated among the socially and medically vulnerable populations.[ii] Europe is bracing for another long-term, deep recession. We have still not recovered from effects of the 2008 crisis, which led to a substantial increase in chronic diseases and a widening health gap. These are linked to the underlying structural determinants of ill-health; poor living and working conditions lead to poor and unequal health and wellbeing gains. This is echoed in recent important reports such at EC/OECD Health at A Glance (2018)[iii], and the WHO European Health Equity Status Report (2019).[iv]

We have all the tools and knowledge of what works to protect people’s health and wellbeing from likely devastating consequences of economic hardship. Austerity in health and social sector spending must be avoided.

With regards to the new impetus given to health(care) in the amended proposal for the EU long-term budget (Multiannual Financial Framework 2021-2027) - while a creation of a stand-alone new and much resourced EU4Health Programme is a welcome move – EuroHealthNet calls for strong synergies and complementarity between health and social policies to be ensured in all its legislative provisions. Despite ‘health’ being taken out of the European Social Fund Plus, we urge you to ensure that social determinants of health and “health in all policies” principles prevail. We just cannot afford to address health or social issues in a disconnected manner. EuroHealthNet restates its long-standing call to urgently reinforce and review the value of primary health care and community health workers, to effectively resource preventative measures, and to build resilient and health-promoting places and communities, in an integrated and people-centred manner. These approaches are cost-effective, bringing high social return on investment.[v] 

The European Commission’s own estimates show that public spending needs for re-orienting EU health systems is "likely to exceed €70 billion, or around 0.6% of EU GDP, though with large variations across countries."[vi] While in the last decade average annual total budgets for health promotion and disease prevention across Europe have stalled at 2.5% of total health spending, 70-80% of health-related costs are caused by largely preventable chronic diseases.[vii] This is where the funds should be more effective and efficient.

In addition, health inequalities reduce economic and social productivity and lead to higher healthcare and welfare costs, estimated at €980 billion per year, or 9.4% of EU GDP.[viii] A 50% reduction in gaps in life expectancy would provide monetised benefits to countries ranging from 0.3% to 4.3% of GDP.[ix] The latest report from WHO Europe also makes a case for accelerated investments in policy areas that affect health equity beyond health services - income security and social protection, living conditions, social and human capital, and employment and working conditions. Importantly and encouragingly, these gains can be achieved “within the lifetime of a single government”.[x] EuroHealthNet reiterates its concern that prioritisation and direct funding for health promotion, disease prevention, and achieving health equity remain insufficient to make the sustainable impacts and maintain the gains achieved in the current post COVID-19 context.

A move to a more socially just recovery from the pandemic and building resilience against the economic recession is good for health and the economy.  It has public support, and remains crucial for reducing health and social inequalities.[xi] We welcome an increasingly more social European Semester as a potential public health ‘game changer’ for steering national reforms in a direction of greater sustainability and equity.[xii] This respects your national rights in the organisation and delivery of social and health care and the competences of the EU treaties objectives for wellbeing and public health protection across all EU policies. This work should be guided by the European Pillar of Social Rights and its imminent Action Plan. Only then can conditions for new European political priorities - green and digital transition ambitions - be realised.

We therefore recommend you take concrete steps in the EPSCO Council to put better health for all, social equity, and sustainable wellbeing at the core of the policy and implementation measures within the amended MFF and EU recovery plans. We strongly suggest you take advantage of the European Semester 2020 cycle which for the first time ever saw health-Country Specific Recommendations issued to all EU Member States.

To make this happen, you can count on our continuous support and collaboration.

Yours faithfully,

Caroline Costongs                                                                          

Director, EuroHealthNet

 

EuroHealthNet is the leading Partnership for Health, Equity and Wellbeing in Europe, with key activities in policy, practice as well as research. Its unique focus is on reducing health inequalities through action on the social determinants of health, integrating sustainable development goals, and contributing to the transformation of health systems. Its main members are authorities and statutory bodies responsible for public health, health promotion and disease prevention at national, regional and local level. www.eurohealthnet.eu

 

See also:

 


  • [viii] Mackenbach JP, Meerding WJ, Kunst AE. Economic costs of health inequalities in the European Union. Journal of Epidemiology & Community Health 2011; 65:412-419.

Call for Action for a comprehensive, sustainable Europe 2030 strategy with a strong social dimension

In 2018, well before the COVID-19 pandemic, there were 110 million Europeans at risk of poverty, of whom 23 million were children.

The European Union as well as the entire world are on the verge of a new economic crisis, which is expected to be even more severe than in 2008. According to the European Commission forecast(1), the outbreak of the COVID19 pandemic is expected to lead the EU into a deep economic recession.

This recession will push more people into poverty, and will further affect those already at risk. The closure of thousands of social services across Europe has already impacted the living conditions of millions of children and adults in need of daily care and support, as well as those of their families and informal caregivers. The COVID19 crisis will directly contribute to growing health and socio-economic inequalities between and within EU Member States.

In 2010, the European Union adopted the Europe 2020 Strategy for smart, sustainable and inclusive growth(2). The Strategy came as a response to the financial crisis that emerged in 2008-2009 and left millions of people unemployed and at risk of poverty or social exclusion. A target was set to lift 20 million out of poverty and social exclusion by 2020. Disappointingly the poverty reduction target was the only target that was not substantially met(3).

The Europe 2020 Strategy is coming to an end this year.

The European Parliament(4) and the Council of the EU(5) have called for a long-term EU Strategy in line with the commitments made on the 2030 Agenda for Sustainable Development. The European Commission, however, has not presented until today any adequate successor to the Europe 2020 strategy, that would set the European Union’s vision and steer the EU’s priorities in the long term.

The European Green Deal(6), although crucial to fight climate change and ensure a better, cleaner and healthier future for all, is not integral enough to be seen as the overall post-2020 EU strategy.

With 1 in 4 Europeans(7) already at risk of poverty and social exclusion and with the catastrophic consequences of the COVID19 pandemic, the EU needs an ambitious, comprehensive and overarching strategy that would encompass the short and long term challenges that it is currently facing.

The EU Alliance for Investing in Children, with the support of the Social Platform and SDG Watch Europe, agree with the European Parliament’s and Council’s position and call the European Commission to launch a proposal for a Europe 2030 strategy that will combine the promotion of:

  • Equality and wellbeing, poverty reduction and social inclusion,
  • Inclusive and sustainable economic recovery, stability and growth,
  • Environmental protection by implementing the European Green Deal
  • Digital transformation

The Strategy should be aligned with the United Nations 2030 Agenda and its SDGs and the Paris Climate Agreement (UNFCCC). The Strategy’s social dimension should be also aligned with the European Pillar of Social Rights, which will set an ambitious poverty and child poverty reduction target, and which will guide EU Member States’ policy making.

A call for a comprehensive, sustainable Europe 2030 Strategy that balances the social, economic and environmental dimensions and that takes into account the most pressing social needs

We call the EU institutions to:

a) Propose and adopt a comprehensive, sustainable Europe 2030 strategy with a strong social dimension

The social aspect of the Europe 2030 Strategy should incorporate the principles outlined in the European Pillar of Social Rights in alignment with the UN Sustainable Development Goals. The announced Action Plan on the Pillar of Social Rights should include an integrated anti-poverty strategy and the European Child Guarantee.

The European Child Guarantee should take a comprehensive approach in tackling child poverty, in line with the European Commission Recommendation on Investing in Children8, considering (and improving where necessary) parents’ access to resources, children’s access to quality and inclusive essential services and children’s right to participate in cultural activities and decision making(9).

b) Set an ambitious target to tackle poverty and child poverty in the EU with a mid-term review

In line with SDG 1, the EU should set an ambitious target to end extreme poverty by 2030 and to reduce the risk of poverty and social exclusion by 50%. This target should take into particular account the furthest left behind(10).

The European targets should be translated into national level targets. The national targets should be based on the EU AROPE(11) indicators; be set beyond GDP rate; and should look at the wellbeing of people not only at national level but also at regional and local levels.

The European Commission should work with Member States to ensure that their targets are adequate and to establish national sub-targets for poverty reduction among groups most at risk,(12) ensuring a just transition for these groups where Europe’s shift to a low-carbon economy is concerned.

Consideration should also be given to agreeing further targets related to health, education and unemployment, especially long-term unemployment and youth unemployment, employment of persons with disabilities. The targets should be reviewed mid-term to assess the realisation of the Europe 2030 Strategy and relevant action taking.

c) Strengthen social and economic policy coordination and monitoring of the Europe 2030 Strategy

The European Commission and the Council should ensure coherence of European social and economic policy in the European Semester by integrating the social indicators of the Europe 2030 Strategy and the European Pillar of Social Rights in the European Semester monitoring cycle. The European Commission should make full use of the flexibility allowed within the Stability and Growth Pact by making use of the ‘exceptional circumstances’ clause to allow social investments needed to implement the European Pillar of Social Rights.

d) Allocate EU funding for the implementation of the Europe 2030 Strategy

We are calling the EU institutions to adopt the ambitious EU budget 2021-2027 and social funding programmes to tackle social and employment challenges proposed by the European Commission on 27 May(13) and ensure that in the European Social Fund Plus:

  • the 25% of earmarking for social inclusion is increased to 27%, as proposed by the European Parliament
  • the 2% earmarking for social inclusion of the most deprived including vulnerable children is raised to 3%, and
  • at least 5% of the ESF+ resources is earmarked to tackle child poverty in all EU Member States.

e) Meaningfully engage civil society and social partners in the design, implementation, monitoring and evaluation of the Europe 2030 Strategy.

This unprecedented global COVID-19 pandemic requires creative and sustainable solutions. This also goes through consulting civil society organisations (European and national) representing diverse interests to understand the needs of the population and be in a good position to respond to those needs.

The adoption of the 2030 Agenda for Sustainable Development and its Sustainable Development Goals (SDGs) was led by a thorough consultative process with civil society participating in consultations and advocating to influence national government’s positions. The Multi-Stakeholder Platform (MSP) on the SDGs, established to support and advise the European Commission on the implementation of the SDGs at EU level, should be reinstated to enable a structured stakeholder engagement in the design, implementation, monitoring and evaluation of the Europe 2030 Strategy.

In addition to the MSP, the EU and its Member States should meaningfully consult children14 and families experiencing poverty and social exclusion and civil society organisations representing them in the design, implementation, monitoring and evaluation of the Europe 2030 Strategy.

This unprecedented global COVID-19 pandemic requires creative and sustainable solutions. This also goes through consulting civil society organisations (European and national) representing diverse interests to understand the needs of the population and be in a good position to respond to those needs.

The adoption of the 2030 Agenda for Sustainable Development and its Sustainable Development Goals (SDGs) was led by a thorough consultative process with civil society participating in consultations and advocating to influence national government’s positions. The Multi-Stakeholder Platform (MSP) on the SDGs, established to support and advise the European Commission on the implementation of the SDGs at EU level, should be reinstated to enable a structured stakeholder engagement in the design, implementation, monitoring and evaluation of the Europe 2030 Strategy.

In addition to the MSP, the EU and its Member States should meaningfully consult children(14) and families experiencing poverty and social exclusion and civil society organisations representing them in the design, implementation, monitoring and evaluation of the Europe 2030 Strategy.

Notes

  1. https://ec.europa.eu/info/business-economy-euro/economic-performance-and...
  2. https://ec.europa.eu/eu2020/pdf/COMPLET%20EN%20BARROSO%20%20%20007%20-%2...
  3. According to the SPC&EMCO review of the Strategy, among the reasons that the target was not met due to the austerity policies that were put in place to tackle the financial and economic crisis of 2008/09. In addition, the European Commission and its Member States deprioritised focusing on quality of jobs and their impact on citizens, on account of ‘simply’ meeting the percentages of the EU having more people in work, resulting for example in in-work poverty and rise in precarious types of job contracts.
  4. http://www.europarl.europa.eu/doceo/document/TA-8-2019-0220_EN.html?redi...
  5. https://data.consilium.europa.eu/doc/document/ST-13432-2019-INIT/en/pdf
  6. https://ec.europa.eu/info/sites/info/files/european-green-deal-communica...
  7. The EU has 446 million inhabitants https://europa.eu/european-union/about-eu/figures/living_en
  8. https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX%3A32013H0112
  9. For more information on the EU Alliance for Investing in Children position on European Child Guarantee please read here http://www.alliance4investinginchildren.eu/proposal-for-a-council-recomm...
  10. This could be monitored additionally by the relative median at-risk-of-poverty gap or the at risk of poverty rate10 with a threshold of 40% of median income
  11. At Risk of Poverty or Social Exclusion
  12. For example, sub-targets may be agreed relating to groups at high risk of poverty or social exclusion (such as children, Roma people, people in migration, elderly and dependent people, people with disabilities, homeless persons).
  13. https://ec.europa.eu/social/main.jsp?langId=en&catId=89&furtherNews=yes&...
  14. In line with Art 12 of the UNCRC

With the support of: SDG Watch Europe, Social Platform

Download the statement as a PDF

Endnote
The EU Alliance for Investing in Children has been advocating for a multidimensional, rights-based approach to tackling child poverty and promoting child well-being since 2014.

This statement was endorsed by the following partner organisations of the EU Alliance for Investing in Children:

Alliance for Childhood European Network Group; ATD Quart Monde; Caritas Europa; COFACE Families Europe; Don Bosco International; Dynamo International – Street Workers Network; Eurochild; Eurodiaconia; EuroHealthNet; European Association of Service Providers for Persons with Disabilities – EASPD; European Anti-Poverty Network – EAPN; European Federation of National Organisations Working with the Homeless – FEANTSA; European Parents’ Association European Public Health Alliance – EPHA; European Social Network – ESN; Lifelong Learning Platform; Make Mothers Matter; Mental Health Europe; Platform for International Cooperation on Undocumented Migrants (PICUM); Roma Education Fund; Save the Children; SOS Children’s Villages International UNICEF EU office

This statement is further supported by the following organisations members of the SDG Watch Europe:

Alleanza Italiana per lo Sviluppo Sostenibile – ASviS
Culture Action Europe (CAE)
EU-CORD network
European Disability Forum
Fair Trade Advocacy Office
Inclusion Europe
IPPF European Network

Contacts:

Europe’s Beating Cancer Plan: time to revisit three key challenges

As public health bodies, EuroHealthNet’s member agencies are at front lines of work with European States and citizens to prevent illness, whether infectious or non-communicable, mental or physical. Throughout the COVID-19 pandemic EuroHealthNet’s members have not ceased working to prevent the causes and burdens of cancers, nor will they stop if vaccines are delivered. Perhaps more than ever, health is a driving factor for Europe working together in union. We must use the lessons of the pandemic to build more sustainable and equitable preventive and health promoting approaches.

The EU flagship initiative Europe’s Beating Cancer Plan, due to be launched this year, is still anticipated. But a consultation has been delayed and we understand the formal launch may require more time in the Commission work schedule1. Delays are understandable, given the need to prioritise the COVID-19 crisis. We urge the EU Institutions that, while being as short as practicable, this delay should be used as an opportunity to firmly focus on the three main identified cancer challenges.

First, the Commission has recognised the huge suffering cancers cause and seeks to put citizens, patients and families at the heart of the Plan. That suffering has been multiplied by COVID-19 both in volume and length. Preventive and diagnostic measures such as screening and health checks have been delayed or cancelled, resources diverted and treatments postponed, while families have been separated and left alone. To put people firmly first, the EU and all its Member States need to urgently and universally implement the agreed, but rarely fulfilled, European Pillar of Social Rights’ principle that ‘Everyone has the right to timely access to affordable, preventive and curative health care of good quality’ – as well as the other principles regarding social rights for all throughout the life course.  

The second challenge is the burdens which cancers impose on society as a whole and particularly health systems. It is estimated that around 40% of cancers are avoidable 2. Yet only 3%3 of health budgets are spent on disease prevention and health promotion. Beating cancer begins with prevention. The current crisis shows how vulnerable our health systems are, despite the valiant work of many. It is clear that health needs a much more prominent place in the EU’s priorities.

Better health promotion and disease prevention means more resourceful, skilled and integrated communities. It requires primary and social services that put prevention and promotion first within a health-enabling practice and policy framework. It means empowering national and sub national health care and social systems to be truly able to tackle disease threats properly. This can be done through improved EU governance, resources, technical and structural support via the European Semester, aided by Cohesion and Social Funds. It also requires agile revision and resourcing of the next EU budget.

It means ambitious Health in All EU Policies approach is needed, underpinned by prevention. It is time to implement and update EU responsibilities for public health and wellbeing so they are fit for purpose and for the 21st century. A strengthened responsible Directorate is needed, with supporting EU Agencies and Programmes shifted to address the key systemic determinants of ill-health, including of cancers. Europe should stop supporting elements that cause diseases such as cancers. This includes factors like pollution, tobacco, alcohol, and unhealthy foods and products at work and in communities. We must avoid unfair blame on individual choices or ‘lifestyles’. Like COVID-19, the faults are systemic, not individual.

Thirdly, Europe’s Beating Cancer Plan will fail and underperform if it does not tackle inequalities which persist across Europe. Disadvantaged people and those in vulnerable circumstances are at higher risk of disease and death from cancer. We hear now about the need to ‘flatten the curve’ of COVID-19 incidence: we need to also flatten the social gradients for all diseases, including cancers. The plan must leave none behind. In an inclusive Europe, all would be protected against the risk factors of cancer.

Health Equity impact assessments are vital. They must be applied to the tackling cancer, and in responses to COVID-19 and its aftermath.

The EuroHealthNet Partnership looks forward to confirmation by the EC of revised schedules. We confirm our readiness to help progress the Europe’s Beating Cancer Plan towards achieving truly successful outcomes and to provide further advice, relevant knowledge and supportive actions where and when possible.

1 https://ec.europa.eu/health/home_en
2 EuroHealthNet contribution to the Roadmap on Europe’s Beating Cancer Plan
3 State of Health in the EU Companion Report 2017

Mental health in the eye of the COVID-19 hurricane

The COVID-19 pandemic is having an enormous impact on mental health and well-being worldwide. During the pandemic, people become more at risk of experiencing, directly or indirectly, confusion, frustration, anxiety, and fear1, sometimes combined with a lack of access to and continuity of care and adequate support for pre-existing ill-mental or physical health conditions. This might lead to the development of harmful coping strategies (such as alcohol or substance abuse, unhealthy dietary patterns and sedentary lifestyles, self-harming behaviour – including suicides, gambling, etc.). Fear and mis- or disinformation also increase the risk of scapegoating and stigmatisation of ethnical or religious groups or of certain professions.

Human contact has been replaced by screens, the increased use of which can negatively impact the mental health and well-being of populations, especially children and teenagers. Work-life balance is under pressure. Frontline workers and teleworking parents are experiencing now how fragile the line between private and professional life can be in these unprecedented times.
Forced home confinement also increases domestic violence against people already in vulnerable situations. Job losses and economic insecurity add up to the list. Now and in the aftermath of the crisis, they (will) have a massive toll on people’s mental health, with a more profound manifestation among lower socio-economic groups. It has indeed become clear that not everyone experiences those impacts equally, and that some in our societies and communities are left behind more than others.2
In face of the current turmoil which our populations are facing, we are encouraging national, European and international decision-makers to take the following aspects into account during and in the aftermath of the crisis:

  1. Integrate mental health concerns into all crisis-response activities.
  2. Communicate efficiently while containing panic and fear.
  3. Protect the mental health of frontline workers.
  4. Recognise the role of informal carers and provide them with adequate support, counselling and training.
  5. Assess and manage risks in work organisations.
  6. Ensure timely access to and continuity of treatment and care for all who need it during and after the pandemic.
  7. Protect the mental health of people in vulnerable situations, including older people.
  8. Adopt a whole-of-society approach to mental health.

1.    Integrate mental health concerns into all crisis-response activities
Mental health should be an integral part of any public health response to the current and future pandemics in order to avoid largely preventable psychosocial stress to individuals and communities, particularly considering the state of disrupted and weakened health and social care systems. “Understanding and addressing mental health and psychosocial considerations will be key to stopping (COVID-19) transmission and preventing the risk of long-term repercussion on the population’s wellbeing and capacity to cope with adversity”.3 As the risks of experiencing mental ill health are likely to rise, prevention of mental health problems, early intervention and access to adequate support should be an integral part of any containment and post-pandemic recovery plan. Consequences of current circumstances such as forced home-schooling, under- and unemployment, business closings, etc. carry the risk of further deepening social and health inequities between and within Member States. Measures to tackle, or at best reduce the latter are therefore vital too, and so would be their impact on mental health.

2.    Communicate efficiently while containing panic and fear
Misinformation or disinformation lead to increasing fears and panic in the population. It is vital for authorities to efficiently communicate on the risks and latest developments related to COVID-19, including deconfinement measures (or exit strategies). The information transmitted should be clear, comprehensible, concise and accurate. For communication to be efficient, it should be tailored to specific target groups, which can have varying levels of health and digital literacy - the latter becomes particularly evident, as vast amounts of health information is delivered digitally nowadays. It should include positive mental health messages that promote psychosocial wellbeing, for example focusing on the many positive community initiatives which are flourishing across our societies. Furthermore, populations should be informed about the trustful sources they should refer to in order to find information related to the pandemic. Self-care strategies should also be promoted in order to empower individuals to limit the impact of these circumstances without diminishing their mental well- being.4

3.    Protect the mental health of frontline workers.
Frontline workers and medical staff are currently confronted with unprecedented harsh working conditions, which require paying special attention to their mental health and well-being. This needs to be addressed and supported through proper risk management, ensuring sufficient staffing, encouragement, peer communication, and support. Access to psychosocial services should be enhanced and made possible taking into account shifts and working time.
What is more, improving working conditions for frontline staff and workers is necessary, e.g. by limiting the number of hours where possible to reduce not only the risk of infection, but ensuring a proper work-life balance, thus enabling rest and recuperation. Ensuring availability and use of proper personal protective equipment is important for physical as well as mental wellbeing by giving a stronger sense of security.
Another element which deeply affects frontline workers is stigmatisation. Considered as carriers of the disease, they can often suffer from discrimination on the basis of their profession. Stigma must be addressed, workers protected, and awareness raised on the key role they play in overcoming the outbreak.

4.    Recognise the role of informal carers and provide them with adequate support, counselling and training.
Many informal carers5 – as the main providers of care to people with chronic conditions or being part of the most-at-risk age group – now find themselves in a particularly vulnerable situation, without adequate support nor protective equipment If their relatives become ill, informal carers will be putting their own health at risk by continuing to care for them. This situation intensifies the pre-existing risks to informal carers’ physical and mental health.
Furthermore, the confinement measures, as well as the de-prioritisation of non-essential treatments, is exacerbating their burden and isolation. While in many cases they serve as the last resort safety net for the person they care for, the risk of becoming ill and therefore unable to ensure the continuity of care is also a significant stress factor for them.

5.    Assess and manage risks in work organisations
The road to recovery following the financial downturn caused by the pandemic is likely to lead to higher workloads with fewer resources in many of the businesses that have been hit financially. Proper assessment and management of occupational health and safety risks, especially psychosocial risks, is crucial. This is the case, in particular, for those workers who are already facing a difficult mental health situation. Social partners have a responsibility to jointly address the workplace health and safety challenges in the aftermath of the pandemic with special attention to the psychosocial risks.

6.    Ensure timely access to and continuity of treatment and care for all who need it during and after the pandemic
The pandemic disrupts mental health support and services. What is more, the unprecedented situation and the distress it causes can negatively impact mental health, and “lead to long-term negative consequences within communities, families” and individuals.6 Access to care and support for people with mental ill health and problems of substance abuse should be ensured. Inter-sectoral referral pathways should be established in order to ensure that children and families with other concerns (such as protection against domestic violence, survival needs, etc.) or more severe distress may access needed services promptly.7 When therapy and counselling sessions are not physically possible, online therapy or via telephone should be made available to continue treatments.

Lessons should be drawn in order to ensure access after the pandemic but also for future crises. Preparedness strategies should for example include the training of frontline workers on essential psychosocial support principles, psychological first aid and how to make referrals when needed. Strengthening primary care, betting on mental health promotion and prevention of mental disorders, and encouraging more integrated and community-based care are some of the measures which would make mental health systems more resilient for the future.

7.    Protect the mental health of people in vulnerable situations, including older persons.
The pandemic has a clear negative impact on the mental well-being of people in more vulnerable situations, including older generations. Socially and economically disadvantaged people are, on the one hand, at greater risk of experiencing mental ill health as a consequence of lockdown measures or of their economic impact. On the other, the mental health of risk groups such as older people, children and women, is under greater pressure.
The pandemic has led governments to take strict confinement measures, which often restrict some basic human rights and personal freedom. The fact that older people and people with underlying health conditions are at higher risk should not justify discriminatory and disproportionate treatment. Everyone should have equal rights. Yet, access to care is sometimes limited based on age. In addition, measures taken within institutions and communities as regards care-dependent individuals do not always respect people’s autonomy and dignity. Furthermore, the messaging around COVID-19 is often stigmatizing towards older people.8
On top of that, there is a clear threat for social distancing to turn into isolation, especially for people who do not have access to technology or are digitally illiterate. A key priority is therefore, in our view, to ensure the mental wellbeing of those at risk. Empowering and encouraging older adults with experience and strengths to volunteer in community efforts – which do not increase the individual risk of getting infected – to fight the pandemic can for example have a positive impact on both individuals and their communities. Their collaboration can be valuable.

Children should not be forgotten. Less affected by the disease itself, they see their access to adequate healthcare and education limited and are also at greater risk of experiencing the negative impacts of isolation and increasing domestic violence. Children should be at the heart of the EU’s crisis de- escalation measures and recovery strategy. Support systems for that group (and their parents) are currently vital and should be expanded (e.g. counselling and consulting centres, help lines etc.).9 In the same vein, women undergoing that same violence as well as older persons suffering from elder abuse - more isolated and at greater risk with the confinement - should benefit from that support too.

8. Adopt a whole-of-society approach to mental health

Actions can only be successful if they adopt a ‘whole-of-society’ approach, involving all sectors and holding mental health, healthcare, social care and welfare programmes, educational settings and local governmental and non-governmental organizations accountable. A pandemic represents an enormous burden for our (mental) healthcare systems and economies, but it also represents an opportunity to reduce existing stigmas concerning mental health and expand offers for people who find themselves in critical situations. Thus, mental health can obtain a proper significance in every national and also European policies. To achieve that significance, mental health should be an integral part of the updated European Commission work programme.

The above-mentioned organisations are willing to provide input and cooperate to any future reflections at European level with regard to mental health in times of pandemic and invite the Commission to start this reflection as soon as possible.

  1. The Mental Health & Psychosocial Support Network
  2. https://eurohealthnet.eu/COVID-19
  3. E.g. Mental health considerations should be taken into account if confinement measures are to be properly followed by populations or to keep frontline workers healthy and engaged in the fight against COVID-19. https://interagencystandingcommittee.org/system/files/2020-03/MHPSS%20CO...
  4. See WHO site dedicated to COVID-19 & Mental Health
  5. Eurocarers defines a carer as a person who provides – usually – unpaid care to someone with a chronic illness, disability or other long lasting health or care need, outside a professional or formal framework.
  6. https://www.mhe-sme.org/wp-content/uploads/2020/04/MHE-Statement-COVID-1...
  7. https://interagencystandingcommittee.org/system/files/2020- 03/MHPSS%20COVID19%20Briefing%20Note%202%20March%202020-English.pdf
  8. https://www.age-platform.eu/policy-work/news/covid-19-older-persons%E2%8... during-pandemic
  9. http://www.alliance4investinginchildren.eu/joint-statement-on-protecting... the-covid19-crisis

AEIP

AGE Platform

AIM

CPME

EPHA

EPR

EUROCADRES

EuroCarers

EuroHealthNet

Gamian Europe

Mental Health Europe

 

Joint statement on protecting children and their families during and after the COVID19 crisis

As COVID19 continues to spread across Europe, it is bringing havoc and devastation to people’s lives, exposing weaknesses of European healthcare systems, and intensifying social inequalities. Although children are considered as a low-risk group, they will be hit hard by this public health crisis. The widening of already existing inequalities means that those who need most support – such as access to adequate healthcare and education – are not receiving it and will struggle most to deal with the catastrophic economic consequences of the pandemic.

In 2018, 23 million children were growing up at risk of poverty or social exclusion in the EU. This number was already unacceptably high for one of the wealthiest regions of the world.

Alarmingly, this number is now expected to increase considerably in the coming year(s) as the economic consequences of COVID19 in Europe take their toll. Various global and European bodies already estimate that the impact of the current pandemic on the European economy will be much more devastating than that of the 2008 recession. Its ultimate scope remains unknown. The fight against poverty and deprivation should not be dropped from the political agenda; on the contrary, investments in our future education, child protection, health and nutrition, will help Europe reduce the damage and avoid future crises.

Evidence and lessons learnt from previous economic crises show that it is people in vulnerable conditions that are the most affected, having fewer means, opportunities, and less resilience to withstand the shocks and observe public health guidelines.

There is no guarantee that this pandemic will be the last for the foreseeable future, nor for how long this virus will remain with us or the extent of our immunity to it. How we prepare ourselves now, strengthen our social protection and health systems, and public services of general interest, will be fundamental. The extent to which we will prioritise leaving no one behind, protecting children from negative economic impacts, and investing in the most disadvantaged in our societies, will be THE test for the EU’s values, identity and democracy.

It is therefore more important than ever to put children at the heart of the EU’s crisis de-escalation measures and recovery strategy. An overarching social and sustainable Europe 2030 Strategy, an ambitious EU long term budget and a holistic Council Recommendation on the Child Guarantee are needed to support the EU’s most vulnerable, including children and their parents in the long run. Meanwhile it is vital to model and keep monitoring both health and socio-economic impacts of mitigation measures impacting populations differently across society.

Eurofound[1], the EU Fundamental Rights Agency[2], the European Ombudsman[3] and the United Nations Committee on the Rights of the Child[4] have already raised their concerns about the impact of the crisis on children.  The partners of the EU Alliance for Investing in Children insist that evidence and data collected across Europe feed into the EU’s policymaking now.

 

Measures to support children and families in the short term

The EU Alliance for Investing in Children strongly recommends the European Commission and EU Member States to provide emergency support to children and families in vulnerable situations by:

  1. Giving children, in particular all children from disadvantaged families and backgrounds particular attention in the design of immediate response measures to the COVID19 crisis.

EU Member States should use all possible measures to promote and protect children’s rights in the current context of home confinement, physical distancing, discontinuity and no access to support services, schools, educators or peers. Measures to mitigate experiences of increasing poverty and inequality should be put in place immediately. For example, home schooling is not accessible to all and especially for children from disadvantaged backgrounds. Where parents in front-line low paid jobs have to continue to work out-of-house or are struggling to work from home and support their children, children may lack the necessary parental support. Others simply do not have the necessary IT equipment and/or stable internet connections, because they cannot afford it. Children are going hungry in families that relied on free school meals, many of which now rely even more on (depleted) food banks who had to reduce their working hours. The children who are badly housed now spend more time indoors, negatively impacting their long-term health. The incomes of vulnerable families are likely to be impacted due to unemployment and lay-offs, particularly those families where parents work in precarious jobs, rely on the informal economy or receive inadequate financial support to meet their household expenses. A common EU-wide commitment to make health services truly accessible to all children from poor and marginalised groups could be taken as a clear indicator of the value of working towards full-inclusion within European society.

In addition, measures are urgently needed to lower the risks of increased psychosocial issues and growing domestic and sexual violence against children and women. The European Commission should support its Member States in a coordinated approach, including in the de-escalation and recovery strategies rolled out at (sub)national level with the aim of strengthening social protection systems and community care in the medium and long term.

 

  1. Directing national budgets and unspent EU financial resources from the 2014-2020 EU funding period to support children and families in vulnerable situations 

National budgets across EU Member States have been redirected and stretched to support health and social protection systems.

At the same time, the European Commission has put forward its financial response towards the COVID19 pandemic[5]. Among other measures, the European Commission suggests a new funding programme, entitled “SURE”, to support EU Member States through loans to fight unemployment. In addition, the Fund for the European Aid to the Most Deprived will introduce the use of food and electronic vouchers to reduce the risk of contamination, as well as the possibility of buying protective equipment for those delivering the aid.

The European Commission also foresees in its proposal that all unspent Cohesion Policy Funds will be redirected towards the fight against the COVID19 crisis. Co-financing requirements will be abandoned as Member States are already using all their means to respond to the crisis and transfers between funds as well as between categories of regions and between policy objectives will be made possible.

The EU Alliance for Investing in Children welcomes the European Commission’s measures to respond to the COVID19 pandemic and strongly recommends EU Member States to:

  • Ensure that national as well as EU funding is being used to support children and families at risk by:
    • Ensuring access to timely and affordable health, educational and social services for all and access to targeted services for the most vulnerable. 
    • Granting financial support to those families affected by the crisis, through increased cash transfers to meet rising costs, emergency payments, access to in-kind support including food/meals, support to pay/delay bills, prevention of evictions and energy cut-offs, enabling them to survive and meet their financial commitments. This should include specific measures to house and support homeless and migrant children and young people and support their opportunities for schooling and education.
    • Addressing issues of inclusion across the digital divide whereby children growing up in the poorest of families have no access to the internet nor to basic IT equipment and hence no access to online information and other resources. This issue is particularly felt when children need to follow online courses of compulsory education and are therefore excluded.
  • Direct national budgets and EU funding support to civil society organisations running programmes supporting families that struggle to continue their operations due to the need for additional staff, protective equipment and financial resources;
  • Ensure that the needed resources reach out to all actors supporting marginalised groups with minimal administrative requirements, including small, grass roots organisations that contribute by supporting the basic needs of families and children;
  • Promote effective coordination and cooperation of all actors at the national, regional and local level, in order to guarantee effective resources allocation.
  • Meaningfully consult children and families experiencing poverty and social exclusion and civil society organisations representing them in the design, implementation and monitoring of Cohesion Policy Funding, thus ensuring its re-direction to where it is mostly needed.

 

Measures to support children and families’ wellbeing in the long term.

The EU Alliance for Investing in Children calls on the EU institutions to adopt measures that will support children and their families in the years to come. 

  1. Adopt a comprehensive, social and sustainable Europe 2030 Strategy that will set a target to halve poverty and child poverty by 2030.

The Europe 2020 Strategy was introduced in the aftermath of the 2008-2009 financial crisis that left millions of Europeans unemployed, at risk of poverty and social exclusion. The EU is currently on the verge of a new, perhaps deeper crisis that will have unprecedented financial impacts on European citizens.

The EU should now look forward and respond decisively to the COVID19 pandemic and to buffer the severe socio-economic consequences that the Union will face in the upcoming years.

Until now, the European Green Deal is the only long-term strategy the EU has presented. Alarmingly, it has not set out an overall post-2020 Strategy outlining the Union’s vision for the upcoming decade. Although the fight against climate change is crucial, the EU should take into account the current challenges that the Union is facing and propose a coherent multi-faceted Europe 2030 Strategy that brings together policy action related to the economy, social inclusion and environmental protection, and is aligned with the UN Agenda 2030 and the Sustainable Development Goals.

Within this framework the EU should set an ambitious target to end extreme poverty by 2030 and to reduce the risk of poverty and social exclusion by 50%. This will lift at least 55 million people, among whom 10 million children, out of poverty and social exclusion by 2030, based on the multidimensional AROPE indicator that measures poverty in all its forms in the EU. This target should also take into account the furthest left behind, which could be monitored additionally by the relative median at-risk-of-poverty gap or the AROPE with a threshold of 40% of median income.

 

  1. Adopt a Council Recommendation on the Child Guarantee that has an integrated approach and includes access to financial resources, children’s access to services, and their participation.

The European Commission has committed to reduce child poverty in the EU by launching a European Child Guarantee to support children’s access to essential services.

The spread of COVID19 clearly shows why all vulnerable people need to be able to access affordable, quality and inclusive services. It has shown that EU Member States should ensure access of all people to health protection and treatment regardless of their financial means or their residence status, but according to their need. At the same time, this crisis has also demonstrated the importance of children’s access to adequate nutrition. In addition, the isolation measures emphasize the significance of access to decent housing, as many families that inhabit in overcrowded accommodations and living areas (eg. Roma settlements, slums and squats) homeless families living in homeless shelters, as well as the families in migration living in overcrowded camps, hotspots or in detention centres find it more difficult to socially distance, or self-isolate putting in danger themselves as well as their co-habitants. Finally, this crisis has stressed the importance of children’s access to education and the preparedness of governments to offer equal access to learning to all children. Although some governments have developed platforms to help children access distance learning, this is not the case everywhere or does not reach all children. Moreover, children in poverty, living in care, in shelters or reception centres often do not have the means to access distance learning platforms.  Equally, protection of children’s rights and privacy online should be ensured.

Although children’s access to essential services is absolutely critical for children’s wellbeing and development, this measure by itself will not reduce child poverty in the EU.

Taking into account the foreseeable socio-economic consequences that the COVID19 pandemic will bring across the EU, it is essential that families are supported holistically as child poverty is very much related to parents in low paid employment or being unemployed or having limited access to social benefits. 

This crisis causes an urgent need to adopt a systemic approach to tackling child poverty and protection against economic shocks. Strong social protection systems, multi-sectoral cooperation and child participation embedded in family, community and policy-making settings will be pivotal to making this happen.

The 2013 European Commission Recommendation on Investing in Children was an ambitious policy framework that took a comprehensive approach on tackling child poverty. It called on EU Member States to develop national child poverty reduction strategies that would ensure -

  1. parents’ access to resources,
  2. children’s access to affordable and quality services and
  3. children’s right to participate in cultural and sport activities and decision making. 

Given the foreseen impacts of the COVID19 crisis on children and their families, this holistic and comprehensive approach should be retained and reinforced in a form of a Council Recommendation on the Child Guarantee.

 

  1. Adopt an ambitious EU budget for the 2021-2027 EU funding period to support child poverty reduction and social inclusion.

The European Parliament in its proposal for the 2021-2027 European Social Fund Plus called for an increased EU budget by 5,9 billion Euros and demanded from EU Member States to earmark 5% of their ESF+ resources to implement the European Child Guarantee.

In addition, the European Parliament increased the ESF+ earmarking for social inclusion to 27% and the earmarking to support the most deprived to 3%.

The COVID19 pandemic is expected to leave millions of Europeans unemployed or in low paid employment. It is also expected to test social and child protection systems. The European Social Fund Plus will be the instrument that EU Member States will need and will use the most in the upcoming years to complement national social security instruments and prevent exclusion.

The European Commission President Ursula Von der Leyen has stated that for the EU to recover from the COVID19 crisis a powerful new budget should be adopted which invests money in a smart and sustainable manner.

Therefore, the EU Alliance for Investing in Children strongly recommends to:

  • the European Commission to update its proposal for ESF+ with a substantial increase of resources, in line with the European Parliament’s proposal, including an earmarking of 5% for the establishment of a European Child Guarantee
  • EU Member States to agree on an increase of the resources proposed for the ESF+, in line with the European Parliament’s proposal, including dedicated funding for the implementation of the Child Guarantee Council Recommendation.

 

Endnote

The EU Alliance for Investing in Children has been advocating for a multidimensional, rights-based approach to tackling child poverty and promoting child well-being since 2014.
This statement was endorsed by the following partner organisations of the EU Alliance for Investing in Children:
Alliance for Childhood European Network Group;
ATD Quart Monde;
Caritas Europa;
COFACE Families Europe;
Don Bosco International;
Dynamo International – Street Workers Network;
Eurochild;
Eurodiaconia;
EuroHealthNet;
European Association of Service Providers for Persons with Disabilities – EASPD;
European Anti-Poverty Network – EAPN;
European Federation of National Organisations Working with the Homeless - FEANTSA;
European Public Health Alliance – EPHA;
European Social Network – ESN;
Lifelong Learning Platform;
Make Mothers Matter;
Mental Health Europe;
Platform for International Cooperation on Undocumented Migrants (PICUM);
Roma Education Fund;
Save the Children;
SOS Children’s Villages International;
UNICEF EU Office

 

Contacts:     

Réka Tunyogi, reka.tunyogi@eurochild.org, Head of Advocacy, Eurochild, +32 (0)2 211 05 54
Katerina Nanou, Katerina.nanou@savethechildren.org, Senior Advocacy Advisor, Child Poverty and Children in Alterative Care,  Save the Children, +32 (0)2 512 78 51
Dorota Sienkiewicz, d.sienkiewicz@eurohealthnet.eu, Policy Coordinator, EuroHealthNet, +32 (0)2 235 03 24
 

Why the Child Guarantee Council Recommendation is best launched in 2020

Today, 23 million children grow up at risk of poverty or social exclusion in the EU. At particularly higher risk of social exclusion, are children in vulnerable situations and disadvantaged groups such as Roma children, children in migration, children with disabilities, children living in institutional care, and children of single-parent or large families. This is unacceptably high for one of the most prosperous regions in the world.

The EU has committed to supporting the eradication of child poverty by developing a Child Guarantee that ensures children in the most vulnerable situations have access to key social rights.

The EU Alliance for Investing in Children welcomes the EU’s prioritisation for the Child Guarantee and is calling on the EU to ensure that the Child Guarantee Council Recommendation is launched in 2020. This will ensure actions are in line with the next EU long-term budget and the programming of these financial resources by the EU Member States.

The EU Alliance for Investing in Children calls on:

  •  the European Commission to present its proposal for a Child Guarantee immediately. We urge the Commission to ensure that the proposed Child Guarantee Council Recommendation builds on the 2013 Recommendation on Investing in Children, which is based on three pillars- access to adequate resources, to affordable quality services and of children's right to participate.
  •  the EU Member States to adopt within 2020 a Council Recommendation on the Child Guarantee which will guide EU and national investments and policy development aimed at reducing child poverty.

Political momentum for a Child Guarantee

The European Parliament has proposed that the European Social Fund Plus (ESF+) allocates 5.9 billion EUR for the implementation of the Child Guarantee1. The European Commission President Ursula Von der Leyen has declared that realising the Child Guarantee will be a priority for her Commission2 and she has entrusted the development and the coordination of the Child Guarantee to Commissioner Nicolas Schmit3 and to Vice President Dubravka Šuica4.

Given this political commitment, in October 2019, the Alliance for Investing in Children5 called on the EU to ensure that the Child Guarantee encompasses not only financial resources but also a policy framework that will guide Member States in tackling child poverty through national policies and through a strategic use of EU funds.

For this reason, the EU Alliance for Investing in Children called EU Member States to adopt a Council Recommendation that will build on the 2013 Recommendation on Investing in Children. The 2013 Recommendation on Investing in Children represents a comprehensive framework for tackling child poverty and social exclusion in a “3 pillar approach” of the EC Recommendation on Investing in Children6. The new initiative should also build on the same horizontal principles, including the recognition of children’s rights and multidimensional nature of the issue.

The recently published intermediate report of the Child Guarantee Feasibility study7also stresses the importance of the EU adopting a Council Recommendation on the Child Guarantee which will build on the comprehensive approach of the 2013 Recommendation on Investing in Children. It also stresses the importance of providing financial resources through ESF+ as well as other EU funding instruments for the implementation of the Child Guarantee.

In January 2020, the EC Communication on a Strong Social Europe for Just Transitions8 declared that the European Commission will present the Child Guarantee in 2021 to ensure that children have access to the services they need and are supported until they reach adulthood. In late January 2020, the European Commission released its work programme for 2020. Although the Child Guarantee was not included as one of the priorities of the EC for 2020, it is welcome that the press release9 accompanying the programme mentioned it as a priority for 2020.

Why the Child Guarantee should be launched in 2020

Over the coming months the European Union will be negotiating the Multiannual Financial Framework (MFF) for the 2021-2027 EU funding period. It is expected that the next MFF will be adopted by June 2020 and the ESF+ as well as other EU Funding instruments (ERDF, AMF) are due to be finalised by autumn 2020.

At the same time, EU Member States are currently developing their Operational Programmes (OPs) which will guide investments in the coming years. The Operational Programmes are expected to be finalised by the end of 2020 and enter into force on the 1 st January 2021. In addition, EU Member States have already started developing their national strategies on poverty reduction and social inclusion which will also include measures for the eradication of the child poverty10. It is essential that any financial resources directed towards the implementation of the Child Guarantee as part of the MFF 2021-27 are invested in line with a Child Guarantee Council Recommendation that will guide Member States’ investments to tackle child poverty in a sustainable and strategic way.

By launching the proposal in 2020 we aim to avoid that EU Member States would have to re-programme the use of EU funded budgets in line with the Council Recommendation and re-open their national strategies on poverty reduction to accommodate the priorities included in the Council Recommendation.

The priority is to prevent:

a) severe delays in the implementation of the Operational Programmes

b) a risk that EU funding is used in an ad-hoc manner rather than for sustainable and strategic investments.

Given the links between the financial aspect and its EU policy guidance, the EU Alliance for Investing in Children urges EU institutions and Member States to start discussions on the Child Guarantee initiative as soon as possible, requiring the Commission’s first proposal to be issued in 2020.

Endnote

The EU Alliance for Investing in Children has been advocating for a multidimensional, rights-based approach to tackling child poverty and promoting child well-being since 2014.

This statement was endorsed by the following partner organisations of the EU Alliance for Investing in Children:
Alliance for Childhood European Network Group;
ATD Quart Monde;
Caritas Europa;
COFACE Families Europe;
Don Bosco International;
Dynamo International – Street Workers Network;
Eurochild;
Eurodiaconia;
EuroHealthNet;
European Association of Service Providers for Persons with Disabilities – EASPD;
European Anti-Poverty Network – EAPN;
European Federation of National Organisations Working with the Homeless – FEANTSA;
European Public Health Alliance – EPHA;
European Social Network – ESN;
Lifelong Learning Platform Mental Health Europe;
Platform for International Cooperation on Undocumented Migrants (PICUM);
Roma Education Fund;
Save the Children;
SOS Children’s Villages International;
UNICEF EU Office.
 
This statement is further supported by the following organisations beyond the Alliance:
Lumos
Centre for Global Health Inequalities Research (CHAIN)
Make Mothers Matter
 

6 Access to resources, access to affordable and quality services and access to cultural activities and children’s participation in decision making https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX%3A32013H0112
10 Aligned with the enabling condition 4.3 of the proposed Common Provisions Regulations 2021-2027

Contacts:

Réka Tunyogi, reka.tunyogi@eurochild.org Head of Advocacy, Eurochild, +32 (0)2 211 05 54

Katerina Nanou, Katerina.nanou@savethechildren.org , Senior Advocacy Advisor, Child Poverty and Children in Alterative Care, Save the Children, +32 (0)2 512 78 51

Joint statement: Prevention at the heart of Europe’s Beating Cancer Plan

Prevention is the foundation of public health policy and central to protecting and improving people’s health and well-being. Europe’s Beating Cancer Plan is a key opportunity to put prevention where it belongs – at the heart of the European Union’s (EU) health agenda.

As a major chronic non-communicable disease (NCD), cancer shares many features with other NCDs, such as cardiovascular disease, respiratory diseases and type 2 diabetes, among others. What connects these diseases is that they are driven by a number of common, modifiable risk factors, especially tobacco and alcohol use, unhealthy diet, insufficient physical activity and air pollution.1 Moreover, NCDs share a high degree of preventability and are exacerbated by socio-economic inequities across the life span.

Many of the main risk factors for NCDs are shaped by social, environmental and commercial determinants which can be addressed through cross-sectoral policies and legislation. Using policies and legislation to create health-enabling environments answers the aspirations of Europeans for a healthy, equitable and ecologically thriving continent for current and future generations.2

Over half a million people under the age of 65 die of NCDs in the EU each year,3 while up to 80% of healthcare spending goes towards treating NCDs.4 The EU has vast potential to deliver human, social and economic added value by adopting a strong prevention agenda and by empowering Member States to develop, implement and enforce ambitious disease prevention and health promotion policies. However, this EU potential remains equally vastly underused.

Therefore, the undersigned organisations urge that a thorough prevention pillar should be included in Europe’s Beating Cancer Plan with special attention to tackling challenges common to all NCDs, and to initiate a process towards a wider EU strategic approach to the prevention of chronic diseases, including mental ill-health.

Especially, we call on the European Commission, European Parliament and national governments to:

Tackle common causes.

Europe’s Beating Cancer Plan should affirm the need to effectively tackle the common risk factors for NCDS, including cancers, and strengthen national and, where relevant, European capacity to implement the World Health Organization (WHO) ‘Best Buys’ and other recommended policies,5 by:

  • Producing an analysis of the gaps in the European response to NCD prevention and developing EU-level policies in its areas of competence to implement the WHO ‘Best Buys’ and other recommended interventions.
  • Developing policy toolkits to support the implementation of the WHO ‘Best Buys’ which fall under national competence.
  • Identifying and adjusting EU-level policies that may dissuade Member States from pursuing national NCD prevention strategies.
  • Ensuring that the EU’s research framework addresses the need for public health policy development, impact assessment, monitoring and evaluation

Put health at the centre of EU policies.

Different policy areas affect health and Europe’s Beating Cancer Plan should adopt a proactive approach to the ‘health in all policies’ obligation in the EU treaties6 to ensure that action to prevent cancers and other NCDs is meaningfully integrated into the European Green Deal, the Farm to Fork and Zero-Pollution strategies, the Economy of Well-Being, the Sustainable Development Goals (SDGs), and other relevant EU activities, by:

  • Strengthening the quality and scope of health and health equity impact assessment for relevant policies and legislation, using improved and continuously updated methodologies.
  • Establishing a reporting process, overseen at a high level in the European Commission, to ensure that all Directorates-General show their contribution to preventing cancers and other NCDs.

Support early detection.

While effective, population-based primary prevention policies create a long-term, sustainable framework for reducing the incidence of cancers and other NCDs, historic exposures to risk factors will continue to generate new cases. Europe’s Beating Cancer Plan should support Member States in implementing appropriate, cost-effective and evidence-based solutions for early diagnosis and screening.7

Ensure governance fit to deliver.

To deliver on its big promise, Europe’s Beating Cancer Plan needs to establish a goal-oriented, inclusive and transparent governance process, by:

  • Setting time-bound, EU-relevant targets related to developments in risk factors, funding and key prevention policies.
  • Establishing an inclusive process to ensure the participation of key health and civil society organisations, including youth.
  • Implementing checks to prevent conflicts of interest and enhance the transparency of decision-making to maximise the integrity and effectiveness of policy outcomes.

The undersigned organisations look forward to contributing to a bold EU response to prevention in Europe’s Beating Cancer Plan to advance the vision of a Europe free from avoidable NCDs.

 

1 United Nations General Assembly (2018) Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases. The World Health Organization (WHO) identifies five main NCDs and five main risk factors. At the same time, more types of NCDs are affecting Europeans and could be prevented by tackling the mentioned, but also other, risk factors.
2 Von der Leyen (2019) A Union that strives for more. My Agenda for Europe: Political Guidelines for the Next European Commission 2019-2024
3 OECD/EU (2016) Health at a Glance: Europe 2016 – State of Health in the EU Cycle
4 European Commission (2014) The 2014 EU Summit on Chronic Diseases. Conference Conclusions
5 WHO (2017) "Best buys" and other recommended interventions for the prevention and control of noncommunicable diseases. The ‘best buys’ contain a collection of evidence-based, ‘best practice’ policies to tackle the main risk factors for NCDs through the creation of health-enabling living environments. Measures include policies on price, marketing, availability, labelling and others. Improving basic education to all is another high-potential policy.
6 Article 168(1) TFEU

7 Especially reviewing and updating, in as far as justified, the Council of European Union Recommendation (2003) on cancer screening.

 

Consultation Responses

EuroHealthNet provides feedback to the EC on the Horizon Europe First Strategic Plan 2021-2024

EuroHealthNet continues to help shape the next EU Research & Innovation programme, Horizon Europe, through replying to a survey on the first Horizon Europe Strategic Plan. This plan will define the strategic orientations for the Commission’s research and innovation investments over the period 2021-2024 and aims to act as a compass to stay on course with its political priorities: a climate-neutral and green Europe, fit for the digital age, where the economy works for the people.

The survey provided the opportunity for feedback on the expected impacts to be targeted by research and innovation within Horizon Europe and the contribution of Research and Innovation (R&I) investments to the EU’s political priorities. Throughout its reply, EuroHealthNet highlighted the importance of jointly considering health, equity and the environment, building on its Horizon 2020 research initiative INHERIT, as well as of ensuring that health promotion and reducing inequalities are important elements of research priorities.

Specific elements that were highlighted include the fact that "behavioural transformations" need to be encouraged through wider enabling conditions for a fair transition, and with a solid understanding of the underlying socioeconomic determinants, and that research funding for health should not just support biomedical sciences, but also prioritise research that focuses on a psycho-social model of health, helping to generate specialist knowledge able to embrace the social determinants of health inequalities and place people at the centre.

The response in full can be found here.

EuroHealthNet provides feedback to the EC proposal on Empowering the consumer for the green transition

In its feedback, EuroHealthNet highlighted that the green transition is an area in which we need to strive for and can deliver a “triple-win”, promoting not just environmental sustainability but also health and health equity. It is crucial that all stakeholders are involved in this transition, including policymakers and the private sector, but also citizens, given that individual (un)sustainable behaviours impact not only the health of our planet, but also our own health. 

EuroHealthNet drew attention to the crucial role that policymakers should play to support people’s capability to make positive changes, by providing clear scientifically sound guidelines at EU level and mandatory standardised EU-wide labelling on food products, which highlights health, social and environmental sustainability aspects. Information must be easy to understand and apply by all; the more complex the information the harder it is for the general population to act on. Given that information and misinformation is increasingly transmitted digitally, this also calls for investments in improving digital literacy. Sustainable and healthy food, as well as other products and services, needs to be affordable, as cost is a key factor driving consumer behaviour, and this can increase health inequalities.

“Business as usual” is not an option, and EuroHealthNet highlighted the urgent need to enforce existing and amended legislations, rather than relying on self-regulation. Policymakers have a duty to facilitate the efforts of front-runner businesses, and to hold accountable those that harm the environment and public health.
 

Read the full response to the proposal here.

EuroHealthNet responds to consulation on the EU Strategy on the Rights of the Child (2021 - 24)

The EU strategy on children’s rights (2021 - 24) will provide the framework for EU action to better promote and protect children’s rights. It will contain a set of measures for the EU to implement, addressing among others (1) the rights of the most vulnerable children; (2) children’s rights in the digital age the prevention of and fight against violence; and (3) the promotion of child-friendly justice. It will also include recommendations for action by other EU institutions, EU countries and stakeholders.

Ensuring children's right to the highest attainable standard of health and to a adequate standard of living is not only in line with our European values, it is essential for strong societal foundations. There is a myriad of data on how the ‘First 1,000 days’ are a critical period for health and cognitive progress, while problems in early life are compounded across the life-course. The EU Strategy on the Rights of the Child is therefore integral to all of the EU’s political priorities of guidelines, and in line with efforts to meet the UN 2030 Agenda and the SDGs. EU-funded research projects coordinated by EuroHealthNet (GRADIENT, 2010-2013 & DRIVERS, 2011-2014) highlighted that for every step down the socio-economic ladder (social gradient), children and young people all across Europe experience a higher level of physical and mental health problems that will affect their future health and life opportunities. This reflects how not all children and adolescents have equal access to the opportunities to lead healthy, happy and prosperous lives. Such avoidable inequities are likely to grow in the context of the COVID-19 crisis; a more substantial and ambitious focus and investments in children and their living conditions is urgently needed. Our research projects showed that improving in particular mothers’ educational levels and employment status, as well as targeted programmes offering intensive support to develop parenting skills have led to the best outcomes for children.

Find our full response to the consultation here.

Find our video on the importance of the first 1000 days of life here

EuroHealthNet responds to consultation on the future of the European Research Area

The European Research Area (ERA) was set up to boost EU coordination and competitiveness in medical, environmental and other types of research. This initiative consists of a communication relaunching and revitalising the ERA in order to (1) make it future-proof; (2) make it better able to address the major challenges of the digital and green transition; and (3) increase Europe’s resilience following the Covid-19 crisis.

The ERA 2015-2020 Roadmap raised the importance of “jointly addressing grand challenges.” The gravity of these challenges, like climate change and the COVID-19 pandemic, the risk of digital divides and growing levels of socio-economic - and closely related - health inequalities have in recent years and months become all the more apparent. The EU must act as a role model globally of how democratic societies can work together to overcome these challenges and achieve ecological, social and economic transition; this hinges on bringing together Europe’s best researchers to design, develop and test new approaches. EuroHealthNet strongly supports efforts to bolster progress towards an ERA that helps meet those needs. COVID-19 has demonstrated all too clearly the central role that public health plays in our societies, and of how economic growth depends on good health and wellbeing. The ERA should therefore also include and coordinate research in the area of public health, prevention and health promotion as a crucial factor in and indicator of the effectiveness of measures to transition to more sustainable and inclusive societies.

Read our full response here.

EuroHealthNet responds to the draft WHO European Programme of Work 2020-2025

EuroHealthNet has responded to the draft WHO European Programme of Work 2020-2025 - United action for better health in Europe. EuroHealthNet welcomes the draft WHO European Programme of Work (EPW) 2020-2025, which identifies the main need, the main health sector situations and responses, and some channels which can be enhanced in the WHO context if taken up. It offers an accurate description of both the needs and challenges of advancing the joint commitment to work together to identify and tackle key barriers and seize new opportunities in health, adopt new ways of working, build on existing successful collaborations, and jointly align support around countries’ national health plans and strategies to help “unite for better health in Europe”. EuroHealthNet members (national public health agencies, regional health authorities and centres of excellence) should be at the heart of that and it needs to reach wider audiences.

In the response, EuroHealthNet has highlighted the need to strengthen health promotion, to invest in the social side of health crisis preparedness, and to work better together toward ambitious outcomes by 2025. Read our full response here

EuroHealthNet responds to consultation on the European Strategy for Data

EuroHealthNet has responded to a consultation for the EU Strategy for Data, which aims to create a single secure European data space. The strategy should make it easier for businesses and public authorities to access an access data to boost growth and create value, while reducing the EU economy’s footprint. Among other things, EuroHealthNet emphasised the need to improve digital literacy to help people manage their data, and for standardisation of data to avoid exacerbating inequalities and to avoid discrimination. It also highlighted the potential of data altruism to improve outreach to vulnerable and isolated communities, and advised against making datasets with sensitive health and social data freely available.

EuroHealthNet provides feedback on European Climate Pact

The European Climate Pact is one of the initiatives launched by the Commission in March 2020 as part of the European Green Deal. It aims to engage citizens and communities at local, regional and national level in the transition to climate-neutrality, including civil society, research organisations, educational institutions, the private sector, consumer groups and individuals. Concretely, the Climate Pact will seek to build on existing initiatives, and encourage societal engagement through three main activity strands: talking about climate change; triggering action; and working together.

EuroHealthNet provided input into the public consultation, helping to shape the final version of the Pact (which is non-legislative). This served for instance to highlight the kinds and sources of information which would be most useful to help trigger action and raise awareness on climate change. Currently, the Commission proposes to focus the Pact on three areas: energy efficiency, low-carbon mobility, and planting trees/green urban areas. Whilst underlining the importance of each of these activities, EuroHealthNet also drew attention to the fact that climate, health and inequalities are strongly interlinked. It indicated its willingness to provide targeted support to foster actions aimed at addressing climate change and environmental degradation, whilst improving health and reducing health inequalities, building on the learnings of the Horizon 2020 INHERIT initiative.

EuroHealthNet responds to EU Tobacco Products Directive Survey

This survey aimed to examine the practical application of Directive 2014/40/EU and its specific provisions, which strengthened existing rules on how tobacco products are manufactured, produced and presented in the EU, and introduced new rules for certain tobacco-related products. The study will assess the level of implementation of the TPD by exploring both achievements and hindering factors.

Despite progress made, the number of smokers in the EU is still high – 26% of the overall population and 29% of young Europeans aged 15-24 smoke. Rates of smoking among (young) females have not been falling urgently as needed, with an increase in occasional smoking and uptake of novel tobacco products consumption. As 56% of smokers start before the age of 18 and 93% before the age of 25, it is essential to prevent young people from taking up tobacco use. TPD has changed EU tobacco control to a significant extent, but there is room for improvement, notably in the area of plain packaging, novel tobacco products and e-cigarettes and their taxation, in particular for the new generation of smokers (young people, females). The EU has legal competences to ensure a high level of public health in the EU internal market, including placement, presentation, content and pricing of tobacco and novel products. Considering levels of cross border trade in tobacco and related products (and novel products most recently) and diverging national legislation (e.g. on smoke-free public spaces), EU-wide rules protecting consumers’ rights and health are increasingly necessary. Achieving TPD’s objective of ensuring a high level of protection of human health, especially for young people, has been undermined by inconsistencies across the applicable legislative acts exploited by tobacco and related industries, in particular by aggressive commercial tactics for new products and stagnation of price increases. Increases in e-cigarette use are widely predicted as availability and publicity multiply, especially in new users; it is necessary to adequately address novel products through regulation and taxation alongside conventional tobacco products. Given the frequent presentation of such products as a ‘healthier’ or ‘safer’ alternative to traditional tobacco products, we strongly urge caution in their active promotion. Until more evidence for the safety of e-cigarettes is presented through rigorous independent reviews, it is prudent to consider them as a potentially harmful and addictive products, to be regulated and taxed in an equivalent manner to conventional cigarettes. Reducing tobacco use among existing consumers and preventing take up by young people are important objectives towards a tobacco-free Europe. Tobacco cessation services which include qualified clinician-led, -monitored and -evaluated use of novel products have a limited place in such strategies, as do improved health literacy and health education as part of wider health promotion approaches. However, insufficiently regulated open markets in this respect are potentially harmful, not least in perpetuating sustainability of multinational.

Read our full response here

EuroHealthNet responds to consultation on Europe's Beating Cancer Plan

Every year, 3.5 million people in the EU are diagnosed with cancer, and 1.3 million die from it. Over 40% of cancer cases are preventable. Without reversing current trends, it could become the leading cause of death in the EU. European Commission has launched a public consultation on Europe’s Beating Cancer Plan, aimed to reduce the cancer burden for patients, their families and health systems. It will address cancer related inequalities between and within Member States with actions to support, coordinate and complement Member States’ efforts.

EuroHealthNet has contributed to the consultation by strongly focusing on health equity dimension of preventing cancers by addressing risk factors, early diagnosis and treatment, quality of life, and social reintegration post-disease. While welcoming the prevention pillar of the Plan, we cautioned against a downstream “lifestyle drift” for disease prevention approaches and shifting the burden on individuals, without integration of the “cause of the causes” - the structural and underlying causes of ill health and disease.

EuroHealthNet provides feedback on the European Climate Law

EuroHealthNet welcomes the European Green Deal and proposed European Climate Law in principle as crucial steps towards ensuring a transition to a more sustainable future. We particularly welcome the Commission’s emphasis on the need for the transition to be “just and socially fair”, and its acknowledgement of the impact of the climate crisis on wellbeing.

EuroHealthNet used the opportunity for feedback to highlight the strong links between the environment, health, and inequalities, and urged the Commission to take these links into account in all aspects of the proposed climate law, building environmental policy whilst looking through health and equity lenses. The INHERIT initiative, which EuroHealthNet coordinated, provides tools and recommendations on how to jointly consider opportunities for a “triple-win” between the environment, health and equity. Drawing on this, we recommend that the studies and assessments foreseen in the climate law take into account inequalities and the distributional impacts of policies or interventions on people across socio-economic gradients. Whilst recognising that EU Institutions have limited competencies to ensure Member States’ compliance with the law, we also wonder if stronger measures could not be included that lie within the scope of their powers to hold EU Member States accountable. Measures that encourage and enable Member States to monitor implementation as well as effects on health and distributional effects, and benchmarking of Member States performance will in this respect be crucial.

The COVID-19 pandemic has demonstrated the perils of not addressing the grave challenges we face in relation to the environment, health and social inequities, and of not addressing these issues in integrated ways. The need to mitigate the economic damage resulting from the pandemic provides an opportunity to do so now, in more systematic ways, and to build an economy fit for the 21st century.

EU Farm to Fork Strategy

EuroHealthNet welcomes the EC’s commitment to develop a Farm to Fork Strategy for sustainable food systems. We strongly support a comprehensive, ambitious and truly transformative transition to European food systems that put people and planetary health, sustainability and social equity at the centre. In a framework of the European Green Deal, this strategy offers an important opportunity to design and deliver a coherent response to current - and future, if business as usual prevails - health, social and environmental challenges related to unsustainable food production and consumption patterns.

Unhealthy diets – major contributor to a NCDs pandemic - are already responsible for over 950,000 deaths and 16 million DALYs lost in the EU (the 2017 Global Burden of Disease). Today's food systems are perpetuating and driving up health inequalities - which is conspicuously missing from this proposed strategic thinking. There is an abundance of evidence to show that sedentary and unhealthy lifestyles of people are heavily influenced by their social, economic, and environmental circumstances and cultural contexts. Therefore, a pivotal role for a modern, fit-for-purpose strategy will be in creating food environments where “a healthy choice is an easy choice” for all. EuroHealthNet counsels against disproportionate focus on ‘downstream’, ‘personalised’ lifestyle-oriented measures (information, education) without real appreciation of the underlying causes of ill-health and disease, the social determinants. They are part of a solution, but not enough to drive the transformative changes needed.

Please find our full response here.

Click here to read our Policy Precis on how Europe's food systems need to change to protect health, increase equality and protect the environment

EuroHealthNet gives feedback to the European Commission’s Roadmap “2020 Strategic Foresight Report"

EuroHealthNet provided feedback on the EC Strategic Foresight exercise, whcih aimed to identify strategic areas where “policy, research and technological developments are most likely to drive societal, economic and environmental change”. Being part of a larger ongoing exercise in the European Union, it’s aim was to help refocus the EU and support its Member States’ efforts towards “future-proofing our policies” to promote more effective response to emerging challenges and opportunities, better linking policies in different areas so they work towards common long-term objectives and re-engage with citizens on Europe’s future. EuroHealthNet welcomed the opportunity to provide input to the Commission’s strategic thinking by responding to the Roadmap on the subject. Anticipating a severe economic and social recession caused by the COVID-19 pandemic, EuroHealthNet advocated for prominent roles for health promotion, disease prevention and decreasing health inequalities in the EU's response.

Read our full response here.

Roadmap Consultation EU Cancer Plan

EuroHealthNet responded to the Roadmap on the EU Consultation on the EU Cancer Plan. We welcome the European Commission’s prioritisation of, and plans to implement, Europe’s Beating Cancer Plan. To be successful, however, ambitious commitment must be to urgently address the large scale of social and economic inequalities in cancer-related health outcomes and in population-wide opportunities for prevention.

Disadvantaged groups in all EU countries and in different regions in Europe are at a higher risk from most of the ‘common’ cancers due to a combination of higher exposure to risk factors, poorer access to cancer preventive measures and health services in general, and less capacity to deal with the social, employment, and financial consequences of the disease. Further disparities may occur in terms of informal care and peer-support required, return to work arrangements or need for long-term care.

 

Please find the full response to the consultation here.

Future mandates/questions for the Expert Panel on effective ways of investing in health

EuroHealthNet has responded to a consultation on the future work of the European expert panel on investing in health.

We asked them to consider:

  • How the sustainable development and green agenda can support health systems
  • How the EU can use its competencies environmental, digital, commercial and fiscal areas to improve health and health equity?
  • How the European Pillar of Social Rights can be used to improve health
2019

Statements

An Economy of Health and Wellbeing

Contribution from the EU4Health campaign group towards the Council Conclusions on The Economy of Wellbeing1.

Increased and maintained action on health and reducing health inequalities should be the central pillar of the Economy of Wellbeing

Pleased with a choice of the Economy of Wellbeing as a priority theme by the current Finnish Presidency of the Council of the European Union, we, civil society organisations united in our EU4Health campaign2, welcome this draft Council conclusions on the subject and put forward some suggestions to consider ahead of the adoption of the text. We trust the conclusions will contribute to the aim and guide implementation of the European Pillar of Social Rights in line with the new EU Strategic Agenda 2019-2024. To this end, however, strong and sustained rights-based focus of the Economy of Wellbeing theme should prevail.

Economy of Health and Wellbeing

We believe that increased and maintained action on health and reducing health inequalities within and between EU Member States should constitute a central pillar of the Economy of Wellbeing.

Recent EU data shows that after years of continuous increase, gains in life expectancy have started to falter or even show signs of reverse. Health inequalities reduce economic and social productivity and lead to higher healthcare and welfare costs. In the European Union, inequalities in health are estimated to cost €980 billion per year, or 9.4 percent of European GDP3. A 50% reduction in gaps in life expectancy would provide monetised benefits to countries ranging from 0.3% to 4.3% of GDP4. Newest report from WHO Europe also makes a case for accelerated investments in policy areas that affect health equity beyond health services - income security and social protection, living conditions, social and human capital, and employment and working conditions. Importantly and encouragingly, these gains can be achieved “within the lifetime of a single government”5.

More emphasis on prevention and mental health to complement the curative approach to dealing with diseases

We welcome the fact that the Economy of Wellbeing place the strategic importance of investing in “effective and efficient policy measures and structures”6, focusing on equal access for all to quality public services including health services, health-enhancing and preventative measures, strong social protection, education and training. To put it in practice, for example, within our call for putting more emphasis on preventive actions to complement the curative approach to dealing with health and diseases, greater efforts to promote mental health should improve early intervention and support to mental health problems. To this end a strategic framework for dealing with the epidemy of Chronic and Non-communicable diseases should be considered.

Balance between social cohesion and economic progress

We are pleased to see references to social, commercial, economic and environmental determinants of health, not forgetting the fiscal and digital factors that offer opportunities for the Economy of Wellbeing that works for all and prioritises a socially fair transition towards a sustainable Europe. Furthermore, we recommend that any considerations that deploy a notion of cost-effectiveness should be first and foremost guided by equity and rights-based principles that underpin our EU values. Health and social policies constitute basic public goods and therefore cannot and must not be judged against how profitable or burdensome they are. The balance between social cohesion and economic progress should also feature more prominently in the EU actions at global level.

We stand ready to further collaboration with the EU and its Member States to develop a common approach to measuring the different dimensions of the Economy of Wellbeing, indicators and impact assessments as well as types of return on investment it contributes to.

EU4HEALTH WORDING SUGGESTIONS

5. Knowledge-based policy-making requires the use of a broad set of indicators and comprehensive impact assessments and evaluation of cost-effectiveness, guided by equity and rights-based principles. While it is widely accepted that GDP alone does not provide a comprehensive picture of people’s wellbeing, further collaborative efforts to develop a common approach to measuring the different dimensions of the Economy of Wellbeing are required.

6. The balance between economic progress and social cohesion lies at the heart of European integration, and should feature more prominently in the EU actions at global level. The European Pillar of Social Rights provides a compass for renewed upward convergence towards better working and living conditions in Europe. Delivering on the Pillar is a shared political commitment and responsibility of the Union and the Member States, and requires continuous progress and in-depth action by both sides. The Economy of Wellbeing contributes to the aim and implementation of the Pillar in line with the new EU Strategic Agenda 2019–2024. Moreover, it contributes to the European Social Model empowering all people by promoting upward social and economic convergence.

[...]

10. Gains in longer life expectancy has started to slow down or even started showing signs of reverse in some EU Member States, regions and population groups. Inequalities in health have not been closed. Poverty and exclusion from the labour market and society exacerbate inequalities and segregation, which can lead to polarisation and instability in society. Despite the various positive developments, one in four children in the EU are living at risk of poverty or social exclusion. Adequate income support, access to social care, affordable and accessible medicines and health services, early childhood education care and housing, and support for labour market integration and reintegration are essential for ensuring equal opportunities for all and reduce unjust and avoidable health inequalities in Europe.

[...]

14. Challenges to people’s wellbeing can best be mitigated when addressed at an early stage, along social gradients and at critical moments throughout the lifecycle. These measures include good-quality early childhood care and education, physical activity, nutrition and other healthy lifestyles as well as preventive measures tackling the socio-economic and environmental determinants of health.

15. Access for all to accessible and affordable medicines and well-resourced health services, health promotion and disease prevention, provided by a sustainable health system, is an essential element contributing to wellbeing and thus to the economy. Investment in health security contributes to effective and timely prevention, detection and response to health threats. For example, antimicrobial resistance, air and noise pollution as well as the increasing occurrence of disasters due to climate change and disease outbreaks have the potential to cause great damage to national economies. Greater efforts to promote mental health and to improve early intervention and support to mental health problems would improve the lives of millions of Europeans and contribute to a stronger economy and better working conditions.

16. The continuous growth of health expenditure is a challenge to national economies in all European countries. It is therefore crucial to address the social, commercial, economic, fiscal, digital and environmental determinants of health and the burden of non-communicable diseases, taking into account the risk factors such as poor diets, air pollution, physical inactivity, and the harmful use of alcohol, and tobacco. Fiscal measures can be used to direct consumption and behaviour. Shortages and high prices of medicines may prevent access to cost-efficient, affordable and innovative pharmacotherapy and threaten the sustainability and financing of health systems. It is therefore essential to prioritise health gains, patient safety and continuity of treatment during the entire pharmaceutical product lifecycle.

17. Technological developments, especially digitalisation and artificial intelligence, are changing the way people’s wellbeing can be promoted and how public services, including social care and health services are delivered. This has the potential to increase the cost-effectiveness and efficiency of services. It is necessary to improve people’s access to their health data and to make eu4health.org #EU4health use of the potential of such data for advancing public health and research while fully respecting applicable data protection rules and ethical principles.

[...]

20. It is crucial for the EU to develop a new post-2020 long-term strategy for sustainable and equitable growth, for the purpose of furthering the EU as the most competitive and socially cohesive economy in the world. It is important for the EU to show global leadership by adopting an ambitious and well-balanced new horizontal strategy in line with the commitments made in the framework of the Pillar and the UN Agenda 2030.

21. DEVELOP cross-sectoral assessment of impacts of policies on wellbeing in order to strengthen knowledge-based policy and decision-making.

[...]

27. ENHANCE a cross-sectoral perspective in the policy positions expressed within the different Council’s preparatory bodies dealing within the European Semester in order to ensure a balanced horizontal analysis, in line with the concept of the Economy of Wellbeing, and the Agenda 2030 for the SDGs.

[...]

30. PROMOTE cross-sectoral collaboration and an enhanced focus on employment, social, health and education policies, and just transition to sustainability agenda within the European Semester process.

[...]

33. ENSURE the wellbeing benefits of digitalisation by accelerating the work on digital solutions in the promotion of health, healthcare and social policies, by strengthening the current initiatives for cross-border exchange of health and social protection data, and by deploying innovative data technologies, including artificial intelligence, while respecting data protection rules, data security and digital ethics, and PROMOTE digital inclusion as well as INVEST in digital skills and literacy, including digital health literacy.

[...]

39. REVIEW the EU Strategic Framework on Health and Safety at Work taking into account working conditions in the changing world of work and psychosocial risk factors.

[...]

42. DEVELOP new initiatives to address disability policies beyond the current European Disability Strategy 2010–2020.

ADOPT a comprehensive post-2020 disability strategic framework that covers all the provisions of the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) and addresses the 2015 Concluding Observations of the UN CRPD Committee.

45a (new) ADOPT A strategic framework for the prevention of Non-Communicable Diseases in Europe.

 
On behalf of the following organisations participating in the EU4Health campaign group:
Alzheimer Europe
EuroHealthNet
European Heart Network (EHN)
European Public Health Association (EUPHA)
European Public Health Alliance (EPHA)
European Respiratory Society (ERS)
EURORDIS Rare Diseases Europe
Global Health Advocates (GHA)

3 Mackenbach JP, Meerding WJ, Kunst AEEconomic costs of health inequalities in the European UnionJournal of Epidemiology & Community Health 2011;65:412-419.
5 ibid 

 

A Call to Action for an Investing in Children Council Recommendation

A Call for Action to European Union Member States for an Investing in Children Council Recommendation

Child poverty in the European Union today

In 2019, 1 in 4 children  in the European Union are still being failed, despite the EU being one of the most prosperous regions in the world.

Child poverty and social exclusion can have lifelong effects in children’s lives, leading to poverty in adulthood. Children who grow up in poverty often have fewer opportunities than their peers to access quality education starting from early childhood education until higher education, and are more likely to experience social exclusion and health problems in the future. They are also less likely to reach their full potential later in life.

In 2013, as part of the Social Investment Package, the European Commission launched the European Recommendation on Investing in Children; Breaking the Cycle of Disadvantage. The 2013 Recommendation was developed to support Member States in taking a comprehensive approach when developing policies for child poverty reduction by ensuring parent’s access to adequate resources, access to affordable quality services, and by supporting children’s participation in decision making.

However, the Investing in Children Recommendation did not have the expected impact on policy reform in the Member States. Still, 23,7 million children today face the daily hardship of growing up in poverty.

The role of the EU as a champion 

The 2021-2027 EU funding period offers a significant opportunity to ensure that EU investments are directed to tackle child poverty and social exclusion across EU Member States. The European Parliament has already championed the development of the Child Guarantee by introducing 5,9 billion EUR in the proposal for the ESF+.

The next European Commission and Ms Von der Leyen’s commitment for the development of a European Child Guarantee as a flagship policy of her Commission offer a momentous occasion to tackle persistent levels of child poverty in Member States and bring positive change for Europe’s most vulnerable children.

The Alliance for Investing in Children welcomes the European Commission’s and European Parliament’s initiatives, notably, the commitment of Commissioner-Designate for Jobs, Mr Nicolas Schmit, to lead on the development of the Child Guarantee and Vice President designate for Democracy and Demography, Ms Dubravka Suica, to coordinate the Child Guarantee.

However, more needs to be done if we want to see systemic and sustainable reforms for tackling child poverty at national level. EU funding alone is not enough – EU Member States need to commit to put an end to child poverty and social exclusion.

Therefore, we bring the following recommendations to EU Institutions and EU Member States urgent attention:

KEY ASKS TO EU AND NATIONAL DECISION MAKERS

1.    We are calling for an EU Commitment in the form of a Council Recommendation on Investing in Children.

The EU needs to update and upgrade its policy framework to guide Member States in their efforts to ensure children who grow up in inclusive and prosperous societies where no one is left behind.

An Investing in Children Council Recommendation will secure national ownership and accountability. It will ensure that EU and national investments, including the Child Guarantee are aligned with national plans that will reflect the principles of the Recommendation and will ensure an integrated response and strategic and sustainable investments.

One of the novelties of the 2013 Recommendation on Investing in Children was the integrated approach it took for tackling child poverty and social exclusion. This integrated approach should be preserved and reinforced.

With an Investing in Children Council Recommendation, we ask EU Member States to make up for previous failures to implement the integrated approach of the previous years to reduce child poverty across the EU.

2.    We are calling EU Member States to develop child poverty reduction plans to realise the Investing in Children Council Recommendation.

EU Member States should define the universal policy measures they have/aim to put in place; as well as the targeted measures to take to prevent and tackle child poverty, at national, regional and local levels.

The national child poverty reduction plans should follow the integrated approach of the Investing in Children Recommendation, ensuring that parents have access to quality employment and child/family benefits, that all children have access to free health care, free education, free childcare, decent housing, and adequate nutrition, irrespective of their residence status, and that children meaningfully participate in the decisions made for their lives.

These plans should include a list and timeline of actions that are to be supported by national budgets and EU funding instruments, including the Child Guarantee.

The plans should form part of the national strategic policy framework on poverty reduction and social inclusion, developed by EU Member States to fulfill the enabling condition 4.3 of the Common Provisions Regulation.

The action plans should be developed and submitted to the European Commission before the beginning of the 2021-2027 EU funding period. The national plans should be reviewed regularly.

3.    We are calling the EU to monitor the implementation of the Investing in Children Council Recommendation at national level through the European Semester.

In 2014 only seven Country Specific Recommendation (CSRs) specifically addressed child poverty; in 2015 it was two; in 2016 one and in 2017 zero. The European Semester is expected to be strengthened in its role to monitor and recommend EU investment priorities to EU Member States. In this sense, the European Semester cycle should reflect the developments in fighting child poverty and social exclusion in EU Member States. For this, clear indicators need to be included in the updated Investing in Children Recommendation that will then feed into the European Semester process.

4.    We are calling for more systematic engagement of civil society at EU and national levels.

Civil society actors are primary interlocutors of children and families in and at risk of poverty. Civil society should be consulted in the designing, implementation, monitoring and evaluation of the national child poverty reduction plans. The European Commission should guide Member States in reaching as many stakeholders as possible as well as enhancing children’s participation. At national level, civil society should be supported to implement projects that will feed into the Investing in Children Council Recommendation.

Children cannot wait. Future generations cannot wait.

We are calling the European Union and its Member States to take the RESPONSIBILITY and ACT NOW to ensure that no child grows up in poverty in the years to come.

Contacts:

•    Katerina Nanou, Katerina.nanou(at)savethechildren(dot)org Senior Advocacy Advisor, Child Poverty and Children in Alterative Care,  Save the Children, +32 (0)2 512 78 51

•    Réka Tunyogi, reka.tunyogi(at)eurochild(dot)org Head of Advocacy, Eurochild, +32 (0)2 211 05 54

Improving Healthcare Access for Marginalised People - Joint Statement Nobody Left Outside

Across Europe, many underserved, marginalised people – including homeless people, lesbian, gay, bisexual, transgender and intersex (LGBTI) people, people who use drugs (PWUD), prisoners, sex workers, and people who are undocumented – are at high risk of poor health related to precarious living conditions and vulnerability. 

These groups face substantial challenges in accessing health and support services owing to a variety of educational, cultural, organisational, administrative, economic and legal barriers, together with widespread stigma and institutional discrimination. In short, some of the people most in need of healthcare in Europe are among the least likely to receive it.

The Nobody Left Outside Initiative calls upon the new European Commission and European Parliament, and EU Member States, to increase EU leadership addressing cross-border health challenges and specifically to address the health challenges of marginalised, underserved people.

Read the full statement here

Statement to the 69th Session of the WHO Regional Committee for Europe on Digital Health Literacy

EuroHealthNet, the European Partnership for health, equity and wellbeing, welcomes the proposed Roadmap for implementation of health literacy initiatives through the life course. We see the calls for action on Promoting Health in the 2030 Agenda as a means by which progress can be achieved and measured, regionally and globally. We are pleased that initiatives to implement the Shanghai Declaration are being actively taken forward by the Regional Office for Europe and Member States.

However, there is much to be done, in some cases urgently. As the Roadmap shows, only 19 European Member States are currently developing relevant policies, despite the definition of health literacy in the WHO health promotion glossary since 1998. That definition has of course partly been overtaken by developments and innovations. They offer both opportunities and challenges, which can be strongly addressed if the Roadmap is taken forward.

Now there is a new impetus which makes health literacy an even more dynamic determinant of health and equity: the digital transformation of societies and systems, including curative, therapeutic and preventive health and care, to which many citizens of the European Region have new rights. It is welcome that improving digital health literacy is among the five strategic directions in the Roadmap.

Point 39 recognises this new dynamic and how integrated approaches are vital, including co-design throughout - from initiation through implementation to evaluation. Point 41 highlights its importance on policy agendas, so we welcome the suggestions in Point 43 for actions in all settings and to decrease inequalities and social exclusion. But we hope these will swiftly become more strengthened commitments, which can be effectively implemented and evaluated in the new partnerships being established, which are imperative for effectiveness.

EuroHealthNet has published our Policy Precis on “Digital Health Literacy: How new Skills can help improve health, equity and sustainability”. It includes stimulating examples from our partners plus recommendations on policies, protections, practices, public and professional engagements which have been developed by our experts and indicates how EU and other programmes can help. 

The Policy Precis is available via our website www.eurohealthnet.eu , plus other relevant outcomes on this subject which we have championed over many years. We are also publishing innovative new information on how to resource such initiatives, as a welcome part of the WHO Europe Coalition of Partners, via an Investment Guide and Online Tool for policymakers and practitioners. This is a vital aspect which is not yet sufficiently addressed in the Roadmap but can be improved.

We look forward to continuing to contribute towards these improvements and to successful outcomes for the Health Literacy Roadmap priorities.

Statement to the 69th Session of the WHO Regional Committee for Europe on Promoting Healthy Equity

EuroHealthNet, the European Partnership for Health, Equity and Wellbeing, welcomes the Draft Resolution “Accelerating progress towards healthy prosperous lives for all, increasing equity in health and leaving no one behind in the European Region.” We congratulate the WHO Regional Office and Member States responsible for organising the conference held in Ljubljana in June, in which EuroHealthNet and many of its members were pleased to participate and contribute.

EuroHealthNet’s mission has prioritised health and social equity within and between European states for over two decades. We shall seek to continue to contribute to the work and objectives of WHO globally and regionally, plus its Member States, as appropriate.

We also continue to advise the Institutions and Programmes of the European Union, as it reaches the landmark of a decade since publication of its Communication “Solidarity in Health” on tackling health inequalities. We already support the EU Joint Action Health Equity Europe, JAHEE. We are reinvigorating our own health equity online Portal. This will update on new initiatives plus new ways to stimulate innovative and equitable investments, as a part of the WHO Europe Coalition of Partners.

The Resolution’s request to place health equity at the centre of sustainable development and inclusive economies offers potentially important progress. We welcome its call for organisations and partnerships such as ours to “engage in and support” its implementation. We will do whatever we can. But in order to do so effectively, we make a respectful request in turn: that true partnership working should be better understood and practiced by all International and national bodies.

Evidence shows that effective involvement of all affected stakeholders at all stages and all levels – including design, initiation and evaluation of actions, as well as implementation – needs to be intrinsic, not just tokenistic. That means better involving dynamic sub national and civil society bodies, who have so much potential to help - if they are valued and their capacities are enhanced.

We and others can be a crucial part of the solutions. No International Organisation, State or stakeholder can achieve these complex, challenging but vital objectives alone. That is partly why progress has been variable and slow. Of course, that is in addition to common wider problems of tackling symptoms rather than underlying causes of inequities, as Professor Sir Michael Marmot has so vividly demonstrated. That too should change.

Our website www.eurohealthnet.eu includes links to our work and yours, from research outcomes to practice models and examples, to policy recommendations. They will support this Resolution’s call and its aim - to accelerate slow progress to overcome the persistent inequities in health and its determinants which blight and damage all our systems, countries and communities.

We know enough to act. We are ready, willing and able to help play our active part.

36 organisations call for EU food policy and Vice President for Food - Open letter to European Commission President von der Leyen

July 17, 2019

(BRUSSELS, BELGIUM) Thirty-six leading campaign groups, farming organizations, and think tanks have come together to call on the new European Commission President to put an EU food policy in place.

In an open letter (see enclosed and HERE) to the Commission President, Ms von der Leyen, the organizations --representing the sectors of farming, fisheries, environment, animal welfare, health, consumers, development, social justice, climate, and forestry-- also called for a European Commission Vice-President to be made responsible for ensuring the transition to sustainable food systems.

Citing the existential threats posed by current trends, the coalition wrote: “Reforming our food systems is therefore an opportunity for the EU and its Member States to address the concerns of many citizens, and is the key to meeting the UN Sustainable Development Goals (SDGs), the Paris Agreement on climate change, and many other commitments to protect people and the planet.”

The letter argues that the creation of an integrated food policy, under the stewardship of a European Commission Vice-President, is essential to coordinate the efforts of the different departments impacting our food systems, including DG AGRI, CLIMA, COMP, EMPL, ENERGY, ENVI, GROW, MARE, SANTE, TRADE and TRANSPORT.

Underlying the results of the EU elections, the signatories highlighted the public will for an integrated food policy to remedy the democratic deficit in food systems and rebalance power. By shifting the focus from sectoral policies (e.g. agriculture, fisheries, health) to food policy, a wider range of stakeholders can be involved in designing and assessing policies.

The open letter echoes the key findings of IPES-Food's February 2019 report, 'Towards a Common Food Policy for the EU'.

Based on a three-year process of participatory research involving over 400 food system actors, the report puts forward a detailed blueprint for reforming European food systems under a Common Food Policy, with 80 concrete reform proposals sequenced over the short-, medium- and long-term.

A shift towards integrated food policies has also been advocated by the European Economic and Social Committee, the Committee of the Regions, the Joint Research Centre, the Commission's Scientific Advice Mechanism (SAM), the European Environment Agency, and the Standing Committee on Agricultural Research.

Joint Letter to the EPSCO Council: Let’s move towards swift transposition of the EU Work-Life Balance Directive!

Brussels, 12th June 2019

As the first legislative proposal to follow the proclamation of the European Pillar of Social Rights in November 2017, the Work-Life Balance Directive is an important stepping stone in the consolidation of existing rights and the establishment of new ones for millions of citizens, and as such, it must now be followed up with enforcement and monitoring.

We, a coalition of European networks of NGOs, urge the national governments to move towards swift transposition after the 13th June meeting of the EPSCO Council.

The transposition phase of this Directive will be of paramount importance, as it is a chance to discuss and to review national work-life balance policies to ensure they fulfill the needs of families in the 21st century, based on values of gender equality, social inclusion and non-discrimination, and boost investment and development of services.

We would like to highlight our key priorities for the future, to deliver a strong message and demonstrate to citizens that the EU works with and for them:

  • Ensure adequate payment of family leaves: Adequate payment of leaves, regardless of the type of leave (paternity, parental, carers), is a key element to ensure non-discrimination of workers based on economic conditions of the family, to rebalance the gender uptake of the leaves and care responsibilities, and to address and prevent poverty of families. There are clear references in the Directive about the need to provide adequate income replacement for family leaves, and this should guide governments in their definition of “adequate”.
  • Boost investment in services to families as a complementary measure: Families need adequately paid leaves but they also rely on care services every day. Transposition of the Directive must be an opportunity to further develop early childhood education and care (accessible, affordable and high quality, below the age of 3), and long-term care (quality, person-centred, for persons in need of support and/or care and a stream of support for carers who have to leave the labour market). These services, especially in rural areas and marginalised communities, are crucial for people to reconcile the different aspects of their lives such as family, work, health, care, leisure, or education.
  • Recognise the diversity of families and their needs: the Directive acknowledges family diversity, with the notion of “equivalent second parent”. We strongly encourage national legislators to insert this diversity into national legislation via the transposition of the Directive, providing a mix of universal support and targeted support to different families in vulnerable or special situations, many of whom are mentioned in the Directive: single parents, parents with a disability or parents of children with a disability, a mental health problem or long-term illness, adoptive parents, multiple births and premature births, persons in need of care and assistance who do not have any family member left. Family diversity also means recognising the different relatives who are family carers: not only children, parents, or spouse/partner or persons living in the same household (as indicated in the Directive) but also additional relatives, such as sibling and grandparents.
  • Promote the use of EU funding programmes to support innovation and upward reforms: The European Structural and Investment Funds, and the post-2020 follow-up of these funds are important to support interventions, namely in the field of disability, health and long-term care, and early childhood education and care, which are extremely complementary to the leaves and flexible working arrangements covered by the Directive.
  • Recognise the important role of civil dialogue and social dialogue: NGOs representing civil society groups concerned by the Directive must be consulted during the transposition process, and the social partners must be encouraged to secure collective agreements on Work-Life Balance to drive change in workplace culture.
  • Bring family policies in line with new labour market realities: To be able to respond to the needs of families, leave provisions must be dissociated by the employment status or type of employment. All workers, including self-employed, workers with atypical or temporary contracts and unemployed must be entitled to the same rights as employees with standard contracts, to avoid further discrimination.
  • Monitoring and reporting: There is a commitment in the Directive to close monitoring by the European Commission of the Directive implementation which requires Member States to collect data on the take-up of leaves and flexible working arrangements. This must include disaggregated data to take into account the needs of specific and vulnerable groups. The creation of a European Work-Life Balance Index and its incorporation in the European Semester process would be a powerful tool to improve the monitoring of Member States’ performance over time.

For more information, contact Pascual Martinez, Policy and advocacy officer, COFACE Families Europe: pmartinez@coface-eu.org

EuroHealthNet General Council Meeting Statement June 2019

The EuroHealthNet General Council, meeting in Madrid 4-6 June 2019, notes:

Learning from the EuroHealthNet Seminar “The role of health professionals in addressing health equity” held in Madrid on 4 June, including:

  • Health equity needs and actions in training programmes in Spain and across Europe;
  • Making use of data in planning to foresee needs and adapt services;
  • Responding to the underlying social, economic and environmental causes of ill-health;
  • Applying health equity in practice, including through use of technological advances;

Learning from discussions at the EuroHealthNet Annual Meeting which focused on:

  • Outcomes of the European Parliament elections held 23-26 May 2019,
  • Progress in inter-institutional negotiations towards a Multi-Annual Financial Framework for the EU 2021-27;
  • Developments towards agreements on the Future of Europe processes;
  • Progress on the European Pillar of Social Rights and towards strengthening of the European Semester for economic and social policy coordination;
  • Outcomes of the 72nd World Health Assembly and relevant progress towards achieving UN Agenda 2030 and Sustainable Development Goals;
  • Preparations for the imminent Ljubljana Conference Accelerating Progress Towards Healthy and Prosperous Lives for all in the WHO European Region and its planned draft Resolution for the WHO Europe 69th Regional Committee in September 2019.

EuroHealthNet reconfirms that the future for health and wellbeing lies with positive and just environments that enable effective health promotion and prevention of diseases, through integrated and community-based services linking people and professionals to shape the everyday conditions for health equity and wellbeing. This is established in the WHO Ottawa Charter; particularly its clear aim to reorient and improve health services.

The effective involvement and engagement of health professionals is a crucial element for this, now and in the future. The responsibility for the organisation and delivery of health and care systems rests primarily within countries. However there is much that can be achieved through shared learning and better use of instruments, which can help improve professional effectiveness for the wellbeing of individuals and communities.

The potential role of wider public health and societal workforce is too often underestimated and overlooked in tackling health determinants. These include professionals and support workers within and outside health and care systems, such as (inter alia) in social, education, environmental, housing, cultural and other municipal systems; informal carers and digital service providers.

EuroHealthNet recognises that such stakeholders and actors, including private and volunteer sector providers, often now act in new multisectoral and multicultural environments and settings. Wider and rapidly changing health determinants are key, including climate change, commercial and political factors. Effective integration, innovative partnership, people centred practices and modern networking are vital for inclusive health promotion.

EuroHealthNet again reiterates its concern that prioritisation and direct funding for public health, health promotion, disease prevention, sustainable development and social equity remain insufficient to successfully achieve all goals and objectives set globally, in the EU, at national and regional levels.

Despite those constraints, EuroHealthNet draws attention to its effective work that means:

  • new ways of improving health, equity and sustainability are being identified, based on new forms of evidence, including the inspiring INHERIT consortium outcomes;
  • new tools are being developed, such as a new Guide for investments in health promoting services; for new funding sources; and towards new financing mechanisms;
  • our Policy, Practice, Research and Communication Platforms are making meaningful contributions towards our REJUVENATE strategic framework. This was agreed by the EuroHealthNet General Council in 2017 and is being actively taken forward as a contribution towards 21st century health promotion and Sustainable Development Goals.
Therefore, EuroHealthNet:
  • will continue to advocate evidence-informed improvements for policies, programmes and activities that implement approaches towards health equity,
  • commits to mobilise the collective knowledge, skills and experience of its Partnership towards improving health equity, including in health and other professional training and development;
  • will contribute towards the effective engagement with all relevant sectors and professions;
  • calls on all relevant institutions, organisations, authorities and agencies in Europe to work to promote and implement wellbeing, cohesion, social justice and equity.
  • urges this to include modern training programmes and enhancing health literacy in all professions throughout public, private and civil society sectors;
  • recommends decision makers at EU and Member State levels to evolve the European Semester towards improving health through more equitable policy tools and instruments;
  • believes that this should more strongly feature systematic reorientation towards positive impacts for health equity within Member States, and include system transformations;
  • restates the need to prioritise integration of EU objectives from 2020 to 2030 to achieve the UN Sustainable Development Goals and contribute to global solutions;
  • urges health and social equity stakeholders and investors to actively engage with national and international programmes for better training, professional development and (digital) health literacy skills for all;
  • encourages the more effective use of improved, ethical and transparent data collection and application;
  • advises this enhanced use of data and knowledge is directed towards planning of public and private systems which are conducive to greatest possible health equity, including towards implementation of effective learning throughout life.

Agreed at Madrid, 6 June 2019

Debates on the Future of Work must include young people’s mental health and well-being

The EUMH Alliance’s response to the Council Conclusions on Young People and the Future of Work
Brussels, 24th May 2019

The European Alliance for Mental Health – Employment & Work (EUMH Alliance) – an informal coalition of European organisations promoting mental health and well-being in the workplace – acknowledges the adoption of the Council conclusions on Young People and the Future of Work and highlights the need to include young people’s mental health in all debates on the Future of Work in the European Union (EU). Addressing youth and in-work poverty and work-life balance should be a must, not an option.

The meeting of EU ministers responsible for education, culture, youth, media, communication and sport took place in Brussels on 22-23 May 2019 and concluded with an adoption of the Council conclusions on Young People and the Future of Work[i]. The EUMH Alliance – Employment and Work welcomes the focus put on the young generation’s future of work. At the same time, in a world where costs related to occupational mental health challenges are substantial[ii] and constantly increasing[iii], the EUMH Alliance calls for the discussions around the Future of Work to address potential negative effects of the new forms of employment on mental health of young workers.

Changes in societies, including technological advances, demographic shifts and the new developments in how the work is organised, encourage the promotion of positive mental health and well-being.  To benefit from such transformations, all young Europeans, especially those with fewer opportunities, must have equal access to resources such as quality education and training, inclusive and preventative to support their good mental health, skills and resilience. For example, flexibility and better time control at work achieved through non-traditional working arrangements (home working, short-term) may allow better work-life balance and decrease stress associated with commuting. However, they may also pose major threats to workers’ mental health and well-being. Our latest podcast highlights the impact of the gig and platform economy (freelancers, digital developers or independent contractors such as Uber or take-away food sites) on young people’s mental health.

In the unregulated labour market, some Future of Work scenarios may suggest that workers in precarious and low-paid jobs, particularly those with low levels of skills and autonomy, could be easily left behind in terms of health and well-being, access to adequate social or legal protection from in-work poverty and discrimination. Indeed, fair remuneration and addressing rapidly increasing in-work poverty rates needs to be at the centre of debates. More efforts are needed to ensure better quality working conditions, including a more predictable income flow and income security. Such employment models should not deteriorate the young workforce’s occupational health and well-being.

There is also an urgent need to review and adapt current Occupational Safety and Health (OSH) strategies so that they pro-actively protect and preserve mental health and well-being of young people in line with the ‘Future of Work’ developments. If we want to ensure solid foundations of cognitive and digital skills– as the Council Conclusions propose – promoting mental health resilience and investing in digital and health literacy of young people is vital.

We, the EUMH Alliance – Employment and Work:

  • Welcome the explicit emphasis given to policies promoting employment and its role in improving the young people’s quality of life.These policies can have a meaningful impact on the social and physical environment of young people.
  • Support the Council Conclusion’s recommendation to promote a cross-sectoral policy approach when addressing youth employment, social inclusion and mental health outcomes, both at national and European levels and in the framework of cooperation between Member States.
  • Recommend using all relevant EU instruments with regard to the trends affecting the nature of work, ensuring implementation of the principles of the European Pillar of Social Rights (EPSR), ‘socialising’ the European Semester and deploying the next EU long-term budget (by means of the ESF+, HorizonEurope, InvestEU, Cohesion Policy Investments or DigitalEurope);
  • Urge the EU and Member States to ensure better implementation and enforcement of the OSH Framework Directive on young workers’ realities while further addressing mental health and psychosocial risks in their OSH strategies, including in the context of changing world of work.

 The EUMH Alliance will continue to actively facilitate constructive dialogue between its members and beyond to improve mental health equity, access to health and social protection and prevention measures of working environments and arrangements for all workers. Addressing youth and in-work poverty and work-life balance are a must, not an option.


The European Alliance for Mental Health – Employment & Work (EUMH Alliance) is an informal coalition of European organisations, the main aims of which are to promote mental health and well-being in the workplace, to advocate for equal access to the labour market for all people experiencing mental ill health and to stimulate policy developments at EU level in these domains. Our membership consists of:


[i] Council conclusions on Young People and the Future of Work (2019). https://data.consilium.europa.eu/doc/document/ST-8754-2019-INIT/en/pdf

[ii] EU/OECD (2018). Health at a Glance: Europe 2018. State of health in the EU cycle. https://ec.europa.eu/health/sites/health/files/state/docs/2018_healthatglance_rep_en.pdf (accessed on 23 April 2019)

[iii] EU-OSHA (2017). Estimating the cost of work-related accidents and ill-health: An analysis of European data sources. https://osha.europa.eu/en/tools-and-publications/publications/estimating-cost-work-related-accidents-and-ill-health-analysis/view (accessed on 23 April 2019)

Joint Statement: Stimulating fresh fruit and vegetable consumption for healthier European consumers

In 2018, EuroHealthNet participated in a Thematic Network, led by Freshfel Europe as part of the EU Health Policy Platform. The Thematic Network is entitled ‘Stimulating fresh fruit and vegetable consumption for healthier European consumers’. The objective of the Thematic Network was to develop a Joint Statement consolidating good practices of communicating fruit and vegetable consumption needs and of how to encourage fruit and vegetable consumption in a changing lifestyle environment in Europe.

The Joint Statement was in collaboration with key health and agri-food related stakeholders throughout 2018, including Appic Sante, BEUC, Bord Bia, ECDA, EFAD, EFCAM, EHN, EPHA, EuroCommerce and EuroCoop. This Joint Statement is therefore a common position of these stakeholders and represents a joint call to action for continued and improved work on stimulating fresh fruit and vegetable consumption throughout Europe to prevent the onset of non-communicable diseases.

This Joint Statement comprises of a set of two papers. The first paper frames and contextualises the current situation of fresh fruit and vegetable consumption in Europe and the second paper provides recommendations for future action.

For the full statement, click here.

Statement on the 2019 European Semester Winter Package

For a PDF-version of this statement, please click here.

Key messages

  • The European Semester Winter Package for 2019 has welcome elements for health, equity, cohesion and wellbeing, but also sets out significant risks that should be addressed urgently and in strategic planning by EU institutions and Member States towards 2030.
  • If the European Semester is to succeed for all people it needs to be better understood by and connected to local realities, needs and communities. EuroHealthNet is working with EC services and on the ground in Member States to help achieve that but needs wider and deeper support from governments and stakeholders.
  • More effective investments in public health and social equity offer significant gains towards implementation of actions outlined by the European Semester and global Sustainable Development Goals, as well as for democratic and institutional sustainability. What matters most for getting ahead in life for people in Europe is good health [i]

As the Spring EU Employment, Social Policy, Health & Consumer Affairs Council (EPSCO) meets to reflect on the contents of the European Semester 2019 Winter Package [ii], EuroHealthNet encourages the European Commission, national and local governments, and relevant stakeholders at all levels to use the Semester process as an important opportunity to engage in a more permanent dialogue with one another to leverage and accelerate progress on health equity throughout the year. 

Despite some modest progress made in communicating the European Semester, too often the language it ‘speaks’ is overly opaque. It lacks explicit relevance for non-economic actors responsible for implementing measures on the ground to engage in dialogues around health and social inclusion. Recent acknowledgement of the value of key stakeholders including responsible authorities, sub national bodies and civil society shows they indeed play important roles to ensure any reforms put forward are informed, designed and implemented effectively. [iii] In EuroHealthNet’s published report [iv] of our work with partners in Member States, we explain why important voices remain unheard. We offer concrete recommendations for using the Semester mechanisms as tools for addressing health equity from a socioeconomic determinants of health perspective. Putting the expertise of public health professionals and authorities central should be key to the Semester process.

Undoubtedly, the Semester’s milestone events – such as the publication of the Country Reports [v] and the Joint Employment Report of the Winter Package, this time – are important moments to draw attention of a wider audience to various assessments of macroeconomic and social situation in EU Member States. However, continuous collaboration between all governance levels and engaging all relevant actors – public health and social experts included – on a more regular basis throughout the year will help move jointly towards advancing social inclusion in line with the Social Scoreboard, guided by the European Pillar of Social Rights. Moreover, since the Semester process acts now as a paramount driver of investment priorities and opportunities within the MFF and next EU funding programmes in EU Member States, it is advisable that the process is as inclusive and understandable for diverse beneficiaries as possible. So far, this has not been the case.

Since its introduction and more recently in our analysis of the Annual Growth Survey 2019, EuroHealthNet has recommended [vi] the European Semester process – predominantly ‘concerned’ about macroeconomic assessment of countries’ expenditures – to prioritise more effective investments and reforms towards sustainable health and care systems including health promotion, disease prevention, and measures tackling health inequalities. We have systematically stressed that these approaches are cost-effective, involve smart use of resources, bring high social return on investment, and are crucial for sustainably reducing health and social inequalities. [vii] Approaching persistent societal problems such as long-term unemployment, for example, has proven much more effective through collaborative, integrated actions with public health communities – as examples gathered by EuroHealthNet show. [viii]  

Main action points arising from the 2019 Winter Package
The European Commission’s 2019 Winter Package contains important data that can help to better understand national contexts, plus recent developments of issues that are central to the public health interest. This should, of course, happen in liaison with other credible sources of health and social data indicators. [ix] We note the reference in the Country Reports 2019 to:

  • Improvements have been observed regarding health system reforms in terms of better effectiveness, accessibility and resilience. Many Member States are pursuing efforts to re-focus health systems towards preventive care, whilst bolstering primary care and better coordination across care settings. On the other hand, the Country Reports for many countries still highlight persisting inequalities both in health opportunities and outcomes. As multiple sources of data show, life expectancy gains have slowed down, progress on healthy life expectancy has not caught up, unmet need for medical care remains up to five times higher for people living below the poverty line (this includes children) as well as the ability to pay for such treatment and care;
  • Despite decline, the share of people at risk of poverty and social exclusion is still unacceptably high, particularly among important, vulnerable population groups. By far, the Europe2020 Strategy’s poverty reduction target remains the only one unlikely to be met by 2020. Years of prioritization of economic and productivity growth over societal challenges of poverty and inequalities have not benefited all equally. Worryingly, in-work poverty has been rising to alarmingly high levels, especially for the self-employed, temporary and part-time workers and for the non-EU migrant employees. This is particularly of concern for those employed in the so-called ‘gig or platform economy’, paired with the increasing digitalisation of society and the future of work;
  • Progress has been made on the implementation of the European Pillar of Social Rights, but the poverty target moving away – as illustrated above - highlights an intrinsic problem of coordination between social, fiscal and economic policies. The European Commission’s recommended tax systems’ reforms aimed to boost redistributive effects of expenditure would likely support more sustainable economies and reduction of income inequalities; however, the risk remains that not all people and in particular the most in need would benefit from such measures, again;
  • All EU Member States were identified with investment needs in the area of “a more Social Europe” (PO4), and a vast majority of countries were urged to invest in enhancing the equal and timely access to quality, sustainable and affordable services, including access to healthcare (primary care); promoting social integration of people at risk of poverty or social exclusion, including the most deprived and children; inclusive, accessible and quality education and training, including early childhood education and care; fostering active inclusion of migrants and marginalised communities; [x]  
  • In addition to a much stronger focus on investment priorities, the 2019 Country Reports provide a detailed analysis of the national and regional disparities and bottlenecks to investment in various areas. The European Commission suggests that Member States should better align their specific investments and the use of the EU funds with the European Semester analysis and recommendations. This is also a key component of the proposals for the next EU budget, the Multiannual Financial Framework 2021-2027.

EuroHealthNet reiterates its long-standing concern that prioritisation and direct funding for health promotion, disease prevention, and actions dedicated to achieving health equity remain stubbornly insufficient to make the sustainable impacts. While average annual total budgets for health promotion across Europe have plateaued at 2.5% of total health spending, 70-80% of health-related costs are caused by largely preventable chronic diseases. [xi] The European Commission’s own implementation analysis of the European Semester process shows that the strengthened Structural Reform Support Programme (SRSP) can help implement sustainable transformations and reorientation which bring multiple co-benefits to States. We note that “In 2018, European Semester country-specific recommendations related to health systems were issued to twelve Member States and, in response to these challenges, a large majority of these Member States have requested technical support in this policy area” through the SRSP in the coming year. [xii] The support measures provided for health systems aim to improve countries’ ability to translate health policies into a more effective delivery of health prevention and care services, as well as to “support fiscally sustainable and comprehensive access to quality healthcare”. 

To this end, EuroHealthNet welcomes the SRSP’s priority for 2019 given to public health and healthcare systems, the fight against poverty, the promotion of social inclusion, social security and social welfare systems. We have had and will continue to engage in constructive contacts with EC services on relevant matters for the EuroHealthNet partnership in Member States. [xiii]  

Encouraged by progress in applying the principles of the European Pillar of Social Rights and its Social Scoreboard – now updated and approved by the Council [xiv] - EuroHealthNet continues to support the Semester’s potential contribution to monitoring social, health and wellbeing developments across Europe. While celebrating successes, we continue to remind that social inclusion policies and universal timely access to quality affordable health and care services can be further promoted in all Member States. Capitalising on boosted resilience and capacities in health and social systems will be vital in 2019 and beyond, given the sustainability risks indicated in the European Semester process so far.

Lastly, but very much not least, EuroHealthNet works with partners for actions towards the universal Sustainable Development Goals (SDGs) Agenda. In the light of the recent EC Reflection Paper showing variable progress on the EU role and performance in that respect as well as in most Member States, we urge actions at all levels underpinned by integration of cross cutting social, economic, and environmental sustainability metrics, indicators and measures in the European Semester, which are crucial towards achieving social sustainability and wellbeing targets. In the light of current economic, social and environmental risk forecasts, we counsel against further delay in universal implementation of the SDGs, with the European Semester playing a pivotal role to support Member States and their citizens.
 


[i] European Commission, Special Eurobarometer “Fairness report” 2017. http://ec.europa.eu/commfrontoffice/publicopinion/index.cfm/survey/getsurveydetail/instruments/special/surveyky/2166

[ii] Discussion paper prepared by the Presidency, in preparation of the policy debate at the EPSCO Council on 15 March 2019 “The European Pillar of Social Rights – an initiative for improving the functioning of the labour

market and social protection systems across the EU. European Semester 2019 - Policy debate”  https://data.consilium.europa.eu/doc/document/ST-6623-2019-INIT/en/pdf

[iii] EuroHealthNet Letter to EPSCO Council, December 2018. The need for more effective investments and reforms towards sustainable health and care systems. https://eurohealthnet.eu/publication/letter-epsco-council-need-more-effective-investments-and-reforms-towards-sustainable

[iv] EuroHealthNet Report, November 2018. The European Semester 2018 from a health equity perspective. https://eurohealthnet.eu/publication/european-semester-2018-health-equity-perspective

[v] European Commission European Semester Country Reports, February 2019. https://ec.europa.eu/info/publications/2019-european-semester-country-reports_en

[vi] EuroHealthNet Report, November 2018. The European Semester 2018 from a health equity perspective. https://eurohealthnet.eu/publication/european-semester-2018-health-equity-perspective

[vii] Masters, R. et al. (2016). Return on investment of public health interventions: a systematic review. Journal of Epidemiology and Community Health, vol.71(8) https://jech.bmj.com/content/71/8/827

[viii] http://eurohealthnet-magazine.eu/exploring-the-links-between-employment-and-health-promotion-within-the-german-prevention-act/ and https://eurohealthnet.eu/publication/consultation-integration-long-term-unemployed-labour-market

[ix] EuroHealthNet Policy Precis, 2018. Making the link: Using Health and Social Data to monitor Health Inequalities. https://eurohealthnet.eu/sites/eurohealthnet.eu/files/publications/PP_%20Health_Inequalities_07_WEB.pdf

[x] Annex D of the Country Reports, 2019 European Semester Winter Package and DG REGIO presentation https://ec.europa.eu/regional_policy/sources/informing/dialog/2019/2019_02_28_alignement_semester.pdf

[xi] ESPN (2018). Inequalities in access to healthcare. Thematic report. https://ec.europa.eu/social/BlobServlet?docId=20373&langId=cs

[xii] European Commission European Semester Country Reports, February 2019. https://ec.europa.eu/info/publications/2019-european-semester-country-reports_en

[xiii] Over 2019, the SRSP will support measures in 23 Member States, in particular in the fields of healthcare systems, education, training and research, labour markets and social policies, migration and social welfare systems. https://ec.europa.eu/info/sites/info/files/file_import/decision-annual-work-programme-2019-and-financing-srsp-annex_en.pdf

[xiv] Pending the outcomes of the Council

Consultation Responses

Response to the draft WHO European Roadmap for implementation of health literacy initiatives through the life course

Overall EuroHealthNet welcomes the Roadmap for the implementation of health liteacy initiatives through the life course. It is a good summary for the specific purposes of the concept, which needs to be established by the Regional Committee of WHO and taken forward seriously. It identifies the main need, the main health sector situations and responses, and some channels which can be enhanced in the WHO context if taken up. It is good to see that strategic approaches are being developed. EuroHealthNet members should be at the heart of that and it needs to reach wider audience. While the initiatives are relevant and reasonable, several concerns about omissions have to be addressed. In terms of the third question about omissions, we have the following concerns.

Value-based healthcare and Task shifting in Healthcare: EuroHealthNet contribution following Expert panel on investing in health hearings

Task-shifting in healthcare systems:

EuroHealthNet welcomes the draft opinion prepared by the Expert Panel on this important issue. The actions recommended are reasonable, given the very limited evidence available which is “much less than desirable” so far. Therefore, EuroHealthNet calls for further evidence, including health equity impact assessments and learning from other sectors, to be gathered with urgency in relevant and comparable settings and models, including via EU research, health, ESIF and other programmes.

It is essential for us to see a strong focus on ensuring task shifting in healthcare strengthens, not undermines, principles of equity and quality. We agree that task shifting should not be viewed in isolation but in the wider context. This means not only within health systems as narrowly defined, but in terms of whole systems towards wellbeing, particularly as established in the integrated goals of UN Agenda 2030 and the SDGs, which we are surprised is beyond the scope of this draft opinion but should be included.

Health and well-being is a product of co-creation by various sectors and ownership levels. Therefore, shifts to new ways of working have multiple societal and governance impacts. Community workers are mentioned, but in terms of “requiring better integration into health and care systems”. In the real world, the opposite might offer better returns: health professions need to be better integrated within wider public health workforces and systems, including public, private and voluntary sectors.

While traditionally the emphasis has been on tasks related to delivery of medical care, it is also other tasks that can be shifted: responsibility for organisation or financing of specific types of care (including health promotion or social care ‘prescribing’), central government to regional authorities or municipalities, public and private insurance tasks. Beyond changing roles of health professionals, changing roles of patients and healthy populations should be considered.

The draft acknowledges that evidence is weak again on patient/carer/public “self-management of chronic conditions” We call on the Panel to consider learning from the CHRODIS Plus[1], Joint Action Health Equity Europe[2] and other relevant EU Joint Actions in these respects, where role shifts need to be integrated.

It is notable that health literacy and - increasingly more importantly – digital health literacy is barely mentioned, but that needs to be pivotal, both for the public, and for training of all relevant professionals.

Value-based Healthcare

The Opinion clearly states that the final goal of European healthcare systems should be achieving universal access, with particular attention to vulnerable (patient) groups. As such, EuroHealthNet certainly shares much of the vision and messages described in the document.

On the other hand, it is important to underline that the document focuses on access to treatments and medicines, and with little or no attention to public health or broader social policies.

This implies that the proposed definition of value-based healthcare is (mainly) meant to support the reform of the way healthcare systems provide care and treatment, and very little for improving prevention policies or policies aimed at improving the social determinants of health. The document could give more attention to social determinants of health, health promotion and prevention. Also, the scope should not be limited to just patients, but addressing more the whole population.

 

[1] www.chrodis.eu

[2] https://jahee.iss.it/

Feedback on the European Partnership for innovative health (Horizon Europe programme)

EuroHealthNet is a European Partnership that aims to improve health, equity and wellbeing through action on the social determinants of health and health inequalities, disease prevention and health promotion. It is therefore a reference to these aspects of public health that we miss in the “Description of the problem the initiative aims to tackle”.

This initiative aims to provide a collaborative platform for pre-competitive research and innovation where small and big companies can join forces with researchers, patients, healthcare professionals and regulators. This cooperation with partners specialised in e.g. pharmaceuticals, diagnostics, medical devices, imaging or from the biotech and digital industries will help speed up the development and uptake of innovation in public health.

While it is true that the EU must deal with an ageing population and an increasing burden of disease, it is also highly important that a problem of health inequalities within and between EU Member States is addressed and prevented. By considering equity and social fairness, innovative health interventions can make a significant contribution to addressing the challenges identified in the proposal. If left unchecked, the transformative potential of digitalisation or innovations in the field of health may remain inaccessible or too costly to benefit all population groups. Better digital health literacy, broader R&I understanding of the structural causes of disease and paths that lead to better health and wellbeing, the continuum of care and life-course approach may offer a much needed change of R&I narrative. Preventative, people-centered and integrated care, addressing key determinants of health, should always constitute an integral part of the European Partnership on Innovative Health.

Health inequalities reduce economic and social productivity and lead to higher healthcare and welfare costs, a point we recommend recognising in the “Expected economic and social impacts” in part C. Evidence shows that in the EU, inequalities in health are estimated to cost €980 billion per year, or 9.4% of European GDP. A 50% reduction of gaps in life expectancy would provide monetised benefits to countries ranging from 0.3% to 4.3% of GDP. Furthermore, for every 1 EUR spent on health promotion, on average, 14 EUR is returned to the economy. Action on health inequalities and the promotion of health-enhancing environments in which people are born, live, work and age represent a good return on investment, can unlock untapped sustainable growth potential, and have strong public support.

The Horizon Europe programme, a basis of the proposed European Partnership, acknowledges that the health challenges faced by the EU cannot be addressed by health systems alone and that they are fundamentally interlinked, global in nature and require multidisciplinary, cross-sectoral and transnational collaboration. Yet, a “health in all policies” principle (Art. 168 TFEU) is clearly lacking from the legal basis of the Partnership proposal, as well as from its expected contribution towards the implementation of the UN SDGs Agenda.

Finally, since the Partnership would include support to public-private collaborations, it should address issues of privatisation, ethics, and commodification of health research results, services and products – potentially undermining efforts towards the Health for All and contributing to widening health inequalities in the EU and globally. Establishing good governance and transparency, cohesion and coordination needs careful consideration. It is essential to ensure a balanced approach towards use of public funds to address issues that concern the public, respond to wider societal needs, and promote scientific collaboration beyond 'traditional' top-down disease-oriented R&I. True partnership for innovative health would mean being non-exclusive of cross-sector and smaller public health stakeholders both at EU and Member State level.

Evaluation of the support to promoting social inclusion, combatting poverty and any discrimination by the European Social Fund.

The European Social Fund (ESF) is the European Union’s main instrument available in EU countries for promoting social inclusion, combating poverty and any discrimination. This public consultation was an integral part of the evaluation of ESF support to promote social inclusion, combat poverty and any discrimination. It seeked feedback from all stakeholders of the ESF in the EU countries, as well as from the wider public.

In our response to this consultation, EuroHealthNet stressed that, although the European Social Fund has played an important role in fostering employability across the EU, persistent disparities within and between countries/regions and certain groups, as well as high and rising in-work poverty rates suggest that the EU policy actions on employment need to be reviewed. Single focus on fragmented labour market policies and skills development are not enough to stabilise work and life conditions for all. To build a productive and resilient society, capable to adapt and withstand economic fluctuations, the ESF should be rooted in holistic approaches that integrate employment with other social inclusion policies, ensuring that no vulnerable groups are left behind. (Un) employment initiatives that reach out towards health and social protection services with an aim to improve health and well-being of people, give them equal opportunities to contribute to a society life-long are good investments.

 

Response to orientations towards the first Strategic Plan for Horizon Europe

With a proposed budget of 100 billion Euro from 2021 to 2027, the Horizon Europe framework programme represents the largest collaborative research and innovation investment in the world and is open to participants worldwide. EuroHealthNet responded to a consultation for the Horizon Europe framework that focused on questions that had not been addressed in earlier consultations. 

An interconnected character of the Horizon Europe (HE) targeted impacts, bringing in more coherence to the overall impact of the programme is welcome. Overall, ‘European Green Deal’, ‘Economy that works for people’, and ‘Europe fit for the digital age’ priorities will be most likely reached through HE investments. From a public health perspective, environments in which we live are key determinants of health and wellbeing, subject to differential and often unfair distribution in populations. R&I should be able to ensure that the transition to greater sustainability is feasible for all and socially fair.

 

Response to the draft opinion on Options to Foster Health Promoting Health Systems by the EU Expert Panel on Effective Ways of Investing in Health (EXPH)

EuroHealthNet responded to the draft opinion on Options to Foster Health Promoting  Health Systems by the EU Expert Panel on Effective Ways of Investing in Health (EXPH). In EuroHealthNet's opinion, the Draft Opinion is a useful contribution to develop strategic approaches to implementing health promotion within the EU region and strengthening the integration of health promotion within health systems. Recognising that health promotion is an essential strategic approach for addressing health inequalities and wider systemic determinants of physical and mental health is a fundamental message that should underpin further action on transformation of health, care and wider public systems in Europe. 

However, we suggest that the Opinion should clarify the responsibilities and accountabilities of the EU and Member States, and to set out potential measures in terms of time frame. EurohealthNet also suggests that several important points should be addressed to strengthen the opinion:

  • The need for a clearer definition or clarification of what is meant by health promoting systems.
  • Include a stronger focus on digital transformation and digital health.
  • Consider the underpinning macro-economic perspective in achieving health promoting health systems.
  • The need for timely evidence and impact assessments as part of policymaking cycles across sectors.
  • Ensure capacity building in human resources, institutional structures and processes for health promotion.
  • Highlight the importance of sustained multi-level partnerships for health promotion.
  • Reinforce leadership and coordination at EU-levels.
  • A stronger emphasis on the reorientation of a medical model of health and addressing the 'lifestyle drift' of health promotion. 

EU Consultation on Horizon Europe Co-design 2021-2024

In EuroHealthNet's opinion, the expected results of the Horizon Europe programme will be truly beneficial and long-lasting only if equity and social fairness are addressed throughout. The programme concerns both the research and innovation area but also the European socioeconomic model at large. Horizon Europe should guarantee that the benefits of furthering evidence and innovation are inclusive and accessible, respond to public needs and advance societal wellbeing.

EC consultation on proposed Digital Europe programme

EuroHealthNet welcomes the initiative to establish the Digital Europe programme to support digital transformation in the EU. Digital technologies offer new opportunities to strengthen – in a balanced way - the public and private sector, and they are crucial to ensure sustainability, growth and equity in the EU. Digital innovation can bring new opportunities to transform health systems, including new approaches to health protection and promotion, treatments and care, accelerated scientific progress for early diagnosis, and prevention of diseases. Importantly, new digital technologies can contribute to reducing inequalities, by lowering costs, expanding coverage and improving access to and quality of public services, such as health, social protection and education.

Read our policy Précis on digital health literacy

Response to the draft Global Action Plan for Healthy Lives and Well-Being for All

EuroHealthNet welcomes the draft Global Action Plan for Healthy Lives and Well-Being for All, which, overall, is a good overview of strategic approaches to strengthening collaboration among multilateral health organisations to accelerate country progress on the health-related SDGs throughout several ‘accelerator’ areas identified. While EuroHealthNet supports strategic approaches and forward-thinking set out throughout the accelerator discussion documents, we believe that important equity-related issues should be addressed and further strengthened in the final Global Action Plan for Healthy Lives and Well-Being for All. In this responsse, we set out how the strategy can better address health inequalities. 

Response to the EC's Public Consultation on Gender Equality

EuroHealthNet responded to the European Commission's Public Consultation on Gender Equality. While progress has been made on gender equality over the last years, the existing gender gap in life expectancy between and within Member States demonstrates an urgent need to address the underlying structural and social factors of gender and health inequalities. Especially women with a low socio-economic status, from disadvantages/socially excluded backgrounds, victims of gender-based violence and migrants require more focused attention in the Commission's efforts to ensure gender equality. 

Response to the draft WHO Global Strategy on Digital Health 2020-2024

EuroHealthNet responded to the WHO Global Strategy on Digital Health 2020-2024.  Overall, it is a good overview of strategic approaches to digital health in-development. It offers an accurate description of both the needs and challenges of adopting digital technologies to improve health from inception to operation. In the context of rapidly-changing environments for health systems and delivery of care, this strategy can serve as a means of promoting equitable, affordable, and universal access to health, as well as fairer opportunities and wellbeing outcomes for all.

While EuroHealthNet supports such strategic approaches and forward-thinking, we believe that important equity-related issues should be addressed and further strengthened in the final Global Strategy on Digital Health 2020-2024. In our response. we set out how the final strategy can do so. 

EuroHealthNet's contribution to the Public Consultation on the Youth Employment Initiative

EuroHealthNet’s contribution focuses on the impact of youth unemployment and exclusion on health outcomes. It highlights the need to address significant societal and economic costs for EU governments through prioritizing long-term life-course investments, such as the EU Youth Employment Initiative. Health inequalities in youth erode the professional development of young generations and their ability to contribute to society, undermine economic growth and prosperity, and increase health, social care and wider public expenditures.

Response to Consultation on European Child Guarantee for Vulnerable Children

EuroHealthNet has responded to a consultation from the European Commission on the EU Child Guarantee for Vulnerable Children. To read the response, click here.

On 30 April, the European Commission published a report in which the responses to the consultation were analysed. The report can be found here.

Response to consultation on the contributions of regions and cities to sustainable development

EuroHealthNet has responded to a consultation from the European Committee of the Regions and the OECD on the role of regions and cities in achieving the Sustainable Development Goals.

Impact Assessment Evaluation and Fitness Check Roadmap of the European Social Fund (2014-2020)

This evaluation will assess:

  • how the European Social Fund (ESF) promotes social inclusion (integrating disadvantaged people into society and ensuring fairer life opportunities for all) and combats poverty/discrimination;
  • structural reforms;
  • the visibility, usefulness, relevance, value for money and effectiveness of ESF measures.

As basis for Public Consultation planned for Q3 2019.

Submitted online on 16 January 2019. See our evaluation here.

Fitness Check Roadmap

 

The European Social Fund (ESF) is a major financial instrument to help pursue the Europe 2020 strategy’s objectives for smart, sustainable and inclusive growth, building up a more social Europe, guided by the European Pillar of Social Rights, and in line with the European Semester. Well-functioning health systems across Europe are central to meeting the headline targets of this strategic vision, particularly those relating to employment, education and social inclusion performance. For EuroHealthNet, ESF represents a valuable instrument to reduce health inequalities between and within EU Member States and further boost investments in structural determinants of health, health promotion and disease prevention measures.

Income and wealth inequality, and the associated levels of health inequalities are persistent and growing in many EU countries. Most EU Member States systematically allocate more than the required 20% of the ESF national resources to promote “social inclusion, combating poverty and any discrimination”(1), showing more ambitious investments are needed to address common social challenges. Evidence from EU funded initiatives that EuroHealthNet has been involved in (ESIF for Health(2), Equity Action(3)) and feedback from our members reflect how ESF can be used to make an impact on social inclusion and the reduction of poverty through action in the areas of health and wellbeing. They reflect that ESF is applied across the EU on a range of initiatives that e.g. improve the provision and quality of health and social care, incl. health promoting services, and strengthen capacities within these systems to provide accessible and quality services, particularly for socially vulnerable people. In many cases, these measures also boost cooperation between health and other key sectors.

Only a fraction of ESF funds are however currently being spent on such actions, and more can be done to maximise the impact of ESF in these areas, and to society at large. More can for example be done to raise awareness amongst professionals in other keys sectors like health about the funds, and to build capacities to enable them to engage, both strategically and practically. Furthermore, the administrative burden of obtaining and administering the funds should be reduced, including for smaller (civil society) organisations that are nevertheless crucial service providers and economic actors. In addition, projects cannot just of themselves deliver systemic change; they must be part of a broader strategy that aims to do this. The EU and its MS must in this respect acknowledge that social policy, health policy, environmental policy and economic outcomes are tightly inter-related, and encourage the implementation of strategies and programmes that deliver co-benefits across sectors. MS must therefore be encouraged to combine the use of EU funds for greater impact, and to invest as much in people (services, capacity building, learning exchange, awareness) as in hard infrastructure projects, as Slovenia and Latvia (4) have done by combining EDRF and ESF to achieve national strategic objectives.

Looking to the future EU budget and its ESF+, we call on these to emphasise the need to address inequalities in our societies, with a focus on fairness, vulnerability and early years. Performance indicators should, in addition, be applied that are aligned to the Social Scoreboard and were possible the SDG indicators, and other reputable measures of equity and wellbeing (5).

 

References:

1. Regulation No. 1304/2013

2. Mc.Guinn J, Ganche M et al. ESIF for For Health. Investing for a healthy and inclusive EU. Milieu, 2018

3. Stegeman, I, Kuipers Y. Health Equity and Regional Development in the EU, Applying the EU Structural Funds, EuroHealthNet, 2013

4. EuroHealthNet Online Magazine, 2018 summer edition

5. A Healthy Budget? Analysis of the MFF 2021-27, EuroHealthNet

2018

Statements

Letter to EPSCO Council: The need for more effective investments and reforms towards sustainable health and care systems

Brussels, 5 December 2018

 

Dear Ministers of Health and Social Policy,

Dear Health and Social Policy Attaches,

 

As the December EU Employment, Social Policy, Health & Consumer Affairs Council (EPSCO) meets within the Austrian Presidency this 6-7 December to discuss the European Semester 2019 cycle, EuroHealthNet recommends you to take this important opportunity to act for more effective investments and reforms towards sustainable health and care systems including health promotion, disease prevention, and measures tackling health inequalities[i]. These approaches are also cost-effective, bringing high social return on investment[ii].  A move to a more social European Semester is good for health, good economically, and crucial for reducing health and social inequalities.

As the Annual Growth Survey 2019 (AGS) shows, despite broadly positive economic progress, significant social inequalities persist and, in some cases, have widened in our societies. The economic recovery has not yet reached all people to an equal degree and inequality of opportunities persist.  Poor living and working conditions are linked with poor and unequal health and wellbeing gains. This situation is echoed in recent important reports Health at A Glance 2018[iii] and Inequalities in Access to Healthcare[iv].

Encouraged by progress in applying the principles of the European Pillar of Social Rights and its – now updated - Social Scoreboard, we support the Semester’s potential contribution to monitoring social, health and wellbeing policies. Social inclusion policies and universal timely access to quality affordable health and care services can be further promoted in all Member States. Building resilience and capacities in health and social systems will be vital in 2019 and beyond given the risks indicated in the AGS.  

EuroHealthNet reiterates its concern that prioritisation and direct funding for health promotion, disease prevention, and achieving health equity remain insufficient to make the sustainable impacts which you as Ministers have recommended in previous Council Conclusions and are reiterated in the AGS. While average annual total budgets for health promotion across Europe have stalled at 2.5% of total health spending, 70-80% of health-related costs are caused by largely preventable chronic diseases[v].  The European Commission’s own implementation analysis of the European Semester process shows[vi] that the strengthened Structural Reform Programme can help implement sustainable transformations and reorientation which bring multiple co-benefits to States.

We welcome the AGS highlighting that “the experience of civil society organisations plays an important role to ensure that reforms are designed and implemented effectively. Yet the degree of engagement with societal stakeholders varies significantly among member states, with insufficient capacity to actively participate in the policy debate being an issue in some of them”. In EuroHealthNet’s published report[vii] of our work with partners in Member States and analysis of the 2018 European Semester cycle, we explain why important voices remain unheard and offer concrete recommendations for using the Semester mechanisms as tools for addressing health equity from a socioeconomic determinants of health perspective. Putting the expertise of public health professionals and authorities central is key to the Semester Process.

This respects your national rights in the organisation and delivery of social and health care, and also enhances the principles of the EU Pillar of Social Rights and the competences of the EU treaties objectives for wellbeing and public health protection across all EU policies. This also prepares for the planned integration of EU health and social programmes within the ESF+ budget provisions of the Multi Annual Financial Framework 2021-27 and helps to prepare towards the new Horizon Europe and Invest EU Programmes.

EuroHealthNet works with partners for sustainable development actions towards the universal SDGs, and urges integration of cross cutting social, economic, and environmental sustainability metrics, indicators and measures in the EU Semester, which are crucial towards achieving social sustainability and wellbeing targets.

I therefore recommend you take concrete steps in the EPSCO Council to put better health for all, social equity and sustainable wellbeing at the core of the policy and implementation measures within the EU Semester in 2019 and beyond.  

To make this happen, you can count on our continuous support and collaboration.

 

Yours faithfully,

Caroline Costongs                                                                           

Director, EuroHealthNet

 

***

EuroHealthNet is the leading Partnership for Health, Equity and Wellbeing in Europe, with key activities in policy, practice as well as research. Its unique focus is on reducing health inequalities through action on the social determinants of health, integrating sustainable development goals, and contributing to the transformation of health systems. Its main members are authorities and statutory bodies responsible for public health, health promotion and disease prevention at national, regional and local level.

www.eurohealthnet.eu

***


[i] EuroHealthNet (2018). EuroHealthNet calls for new and improved approaches to financing for health promotion and health equity. Statement. https://eurohealthnet.eu/media/news-releases/eurohealthnet-calls-new-and-improved-approaches-financing-health-promotion-and

[ii] Masters, R. et al. (2016). Return on investment of public health interventions: a systematic review. Journal of Epidemiology and Community Health, vol.71(8) https://jech.bmj.com/content/71/8/827

[iii] OECD (2018). Health at a Glance: Europe 2018. State of Health in the EU Cycle. https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-europe-2018_health_glance_eur-2018-en

[iv] ESPN (2018). Inequalities in access to healthcare. Thematic report. https://ec.europa.eu/social/BlobServlet?docId=20373&langId=cs

[v] ibid

[vi] Health-related Country Specific Recommendations receive the least attention and the lowest level of national implementation among all other areas (see: European Commission Communication on the CSRs 2018 https://ec.europa.eu/info/publications/2018-european-semester-country-specific-recommendations-commission-recommendations_en)    

EuroHealthNet becomes acredited to attend meetings of the WHO Regional Committee for Europe

Oral Statement on EUR/RC68/13 Engagement with non-State actors: Accreditation of regional non-State actors not in official relations with WHO to attend meetings of the WHO Regional Committee for Europe

September, Rome

Madam Chair, Mr President, honourable ministers, distinguished delegates, dear colleagues,

On behalf of all 19 non-State actors[1], we thank the Regional Committee for approving our accreditation, in line with the Framework of Engagement with non-State actors (FENSA). It is with great honour that we  will continue to participate in the WHO Regional Committee for Europe and we would like to reaffirm our commitment to working with all stakeholders towards our shared goals.

The commitment to engage with non-State actors demonstrates to us the importance that is given by WHO to collaboration with civil society. As representatives of citizens, patients, healthcare and public health professionals, civil society organisations, we work for the common good, and we can and should play a vital role in achieving the sustainable development goals, Health 2020 and WHO’s general programme of work. 

We look forward to our continued collaboration and participation in the WHO Regional Committee for Europe. 

Thank you,

On behalf of the 19 accredited non-State actors

Alzheimer Europe  • Association for Medical Education in Europe • Center for Health Policies and Studies (PAS Center) • Centre for Regional Policy Research and Cooperation “Studiorum” • Eurocare (European Alcohol Policy Alliance)  • EuroHealthNet • European Association for the Study of the Liver • European Cancer Organisation  • European Federation of Allergy and Airways Diseases Patients’ Associations  • European Federation of the Associations of Dietitians  • European Forum for Primary Care • European Forum of Medical Associations • European Forum of National Nursing and Midwifery Associations  • European Medical Students’ Association  • European Public Health Alliance  • European Public Health Association • Health Care Without Harm • Standing Committee of European Doctors • Wemos

 

 

[1] As listed in EUR/RC68/13 Engagement with non-State actors: Accreditation of regional non-State actors not in official relations with WHO to attend meetings of the WHO Regional Committee for Europe.

Statements to the 68th session of the WHO Regional Committee for Europe

Health ministers and high-level representatives of the 53 Member States of the WHO European Region as well as partner organisations and civil society will take part in the 68th session of the WHO Regional Committee for Europe in Rome, Italy.

EuroHealthNet is presenting two statements. The full text can be found below.

On Item 5.d: ‘Can people afford to pay for health care? New evidence on financial protection in Europe’

We stress the need for European Member States to urgently act on the guidance issued. Health ministries should use available policy instruments such as the European Pillar of Social Rights and the Semester, the annual economic and fiscal guidance for individual Member States.

At the EU level, financial protection must be incorporated into the social fairness legislation and the 2019  Semester process.

On Items 5.e and 5.j,  Reports on the WHO high-level meetings on Health Systems in Sitges and Tallinn

We note that non-communicable disease epidemics are growing and are strongly related to the persistent health inequalities in Europe. Tackling NCDs requires urgent and joint action where health systems have a pivotal role. Most of the factors associated with NCDs are largely preventable, and require a stronger health promotion and disease prevention response.

Health systems must engage in tackling broader societal determinants, in particular with regard to the social gradient of inequalities, using their knowledge and experience.

As the WHO wants to transform health systems and not leave anyone behind, we suggest developing a much more explicit and meaningful approach to integrating health promotion and social determinants- approaches throughout the system, with an increased role in primary care services.

Joint Position Paper on The European Commission’s InvestEU proposal

This Position Paper represents the view of the main representatives of the social services, health, education, social housing and ageing sectors at European level. We have joined forces to help unlock investment into local innovative social infrastructure projects which would help to further improve the quality of service provision across the continent. Moreover, by delivering services based on the needs of the people they serve, Public Authorities will both increase public satisfaction and reduce costs.

How can the EU’s post-2020 budget fight child poverty and social exclusion? Recommendations for the ESF+ and the Common Provision Regulations

The EU Alliance for Investing in Children, of which EuroHealthNet is part, has issued a statement including recommendations for the ESF+ and Common Provision Regulations

Poverty severely impact children’s health and their ability to develop their talents and capabilities, to establish relationships, and to learn. Poverty is carried on from one generation to another and severely undermines social cohesion and participation in society. If Member States and EU institutions want to fulfil their “commitment to work towards a social Europe” as declared in the joint Proclamation of the European Pillar of Social Rights, Member States need to start by firmly reducing poverty and investing in children and families in vulnerable situations.

 

Letter to EPSCO council: It’s in your hands – the fate of working parents and carers across Europe depends on you

OPEN LETTER

It’s in your hands – the fate of working parents and carers across Europe depends on you

Time for the EPSCO Council to adopt a position on the EU Work-Life Balance directive

Brussels, 18 June 2018

Dear Ministers,

We represent, via our European umbrella organisations, 3.471 NGOs and 89 trade union confederations. Our call is joint with the Presidents and Vice-Presidents of three political groups in the European Parliament, the Rapporteur and shadow Rapporteurs of five political groups, and the Presidents and Vice Presidents of three Intergroups and Coalitions of the European Parliament, together with the Presidents of two groups in the European Economic and Social Committee.

We urge you to respect European citizens and their representatives by moving forward and adopting a Council position on the proposal for a Directive on Work-Life Balance for parents and carers at your meeting on 21st June 2018.

On this date, you will be asked to position yourself in favour or against the Council position on the EU Work-Life Balance Directive. With your decision, you will not only express your country position on a text, but you will also decide on the fate of millions of parents and carers in the European Union: people who struggle every day to juggle their responsibilities towards their children, families and other people with support needs, with their working lives.

The existing EU legal and institutional framework fails to sufficiently address challenges faced by its citizens and does not provide adequate solutions for the needs of modern societies. This proposed directive includes provisions for improving equal sharing of work and care between women and men, by introducing minimum standards for paid paternity leave,  paid parental leave, carers leave and flexible working arrangements for parents and carers.

The proposal for a Directive on Work-Life Balance is the right way forward and we urge you to adopt a Council position and not further delay the adoption of a general approach.

All EU Heads of State and Governments, together with the EU Institutions, proclaimed the European Pillar of Social Rights in Gothenburg in November 2017 and this directive is the first concrete output that would transform the principles of the Pillar into reality, providing improvements to the lives of millions of parents and carers.

The European Commission published the proposal for a directive on 26 April 2017. The European Social and Economic Committee delivered its opinion, in broad support of the proposal, in December 2017. The European Parliament has a clear calendar of works: the Legal Affairs Committee and the Women’s Rights and Gender Equality Committee have already voted on their respective opinions and the Employment and Social Affairs Committee will vote in the coming weeks. All these procedures are transparent and European citizens can follow them step by step, exposing the elected representatives to scrutiny.

On the contrary, the deliberations in the Council are not subject to the same level of transparency. This can lead to indefinite postponement of decisions, with the excuse that a compromise cannot be reached among the national delegations with citizens left in the dark about why there is a lack of progress.

More than a year after its publication and one year from the 2019 European elections, it is now time for you to take up your responsibility and secure that citizens recover trust in the European project and its social dimension.

Working parents and their families as well as carers and those who depend on them do not have time to lose.

Please do not waste this opportunity to show your citizens you care about them.

Signatories:

COFACE Families Europe

AGE Platform Europe

Alzheimer Europe

Autism Europe

European Disability Forum

EuroCarers

Eurochild

EuroHealthNet 

European Network for Independent Living

European Women’s Lobby

European Youth Forum

ILGA Europe

Inclusion Europe

International Federation for Spina Bifida and Hydrocephalus

Make Mothers Matter

Mental Health Europe

Social Platform

SOS Children’s Villages International

 

European Trade Union Confederation – ETUC

 

Udo Bullman MEP, S&D President

Philippe Lamberts MEP, Greens/EFA Co-President

Monika Vana MEP, Greens/EFA Vice-President

Gabriele Zimmer MEP, GUE/NGL President

 

David Casa MEP, EMPL Rapporteur and EPP EMPL coordinator

Maria Arena MEP, S&D EMPL shadow rapporteur

Agnes Jongerius MEP, S&D EMPL coordinator

Vilija Blinkeviciute MEP, S&D FEMM shadow rapporteur

Iraxte Garcia-Perez MEP, S&D FEMM coordinator

Jana Zitnanska, MEP, ECR EMPL shadow rapporteur

Ernest URTASUN MEP, Greens/EFA FEMM shadow rapporteur and co-coordinator

Terry Reintke MEP, Greens/EFA FEMM co-coordinator

Tania Gonzales Penas MEP, GUE/NGL EMPL shadow Rapporteur

 

Olga Senhalova MEP, President Disability intergroup

Brando Benifei MEP, Vice-Chair, Disability Intergroup

Marek Plura, MEP, Vice President of the Disability Intergroup

Miriam Dalli MEP, Chair of the Coalition for Mental Health and Wellbeing in the EP  

Daniele Viotti MEP, co-Chair of the LGBTI Intergroup

 

Gabriele Bischoff, President of the Workers' Group, European Economic and Social Committee.

R.A. Arno Metzler, President of the Diversity Europe Group, European Economic and Social Committee

Put strong investments in public health at heart of a more social European Semester and the next EU’s budget.

On 18th June, EuroHealthNet sent the following open letter to Health and Social Ministers, and Health and Social attaches.

Brussels, 18 June 2018

Re: Put strong investments in public health at heart of a more social European Semester and the next EU budget.

Dear Ministers of Health and Social Policy,

Dear Health and Social Policy Attaches,

Ahead of the 21-22 June EPSCO Council, I am writing to you on behalf of EuroHealthNet, a European partnership of not-for-profit organisations working on reducing health inequalities.

As the EPSCO Council meets to discuss the 2018 European Semester, EuroHealthNet takes this opportunity to highlight the entry points that the Semester process offers for shifting investments from health care to financing for health promotion, disease prevention and health equity[1].

Inequality has widened in our societies. The economic recovery has not yet reached all members of society to an equal degree and inequality of opportunities persist. Encouraged by progress in applying the principles of the European Pillar of Social Rights and its Social Scoreboard to date, we support the Semester’s potential contribution to monitoring social, health, and well-being policies. A move to a more social European Semester is good for health and for reducing health inequalities. However, we also need to see it followed by ambitious investment commitments.

EuroHealthNet reiterates its long-standing concern that prioritisation and direct funding for health promotion, disease prevention, and health equity remain insufficient to make sustainable impact. European Commission’s own analysis of the European Semester’s process shows that health-related Country Specific Recommendations (CSRs) receive the least attention and the lowest level of national implementation of all other areas. Furthermore, the health-related CSRs tend to neglect reference to strengthening primary, community-based care and preventative approaches, as well as integrated and inter-sectoral cooperation. There appears to be little opportunity for relevant stakeholders at national and local levels to engage and contribute their insight and good practices – this is fundamental to national ownership and high implementation rate.

EU level technical and political guidance as to which areas require urgent reform must be in line with EU budgetary plans, in particular the current legislative proposals on various funds and programmes under the Multiannual Financial Framework 2021-27. That is why it will be important to bring the messages of health promotion and health equity to the attention of the EU Council scheduled to hold a political debate on the next EU’s long-term budget at its meeting of 28-29 June 2018. It is crucial that Ministers for Health and Social Policy get engaged in those discussions, as the issue is too important to be left to pure economic and financial deliberations.

We trust you will do all that is in your powers to place health equity and health promotion high at the European Semester and the next EU’s budget’s political agenda. Investing in what keeps people healthy and in the places and communities in which they live, learn and work should be one of the measures to support health systems’ fiscal sustainability and capacity. In addition, health promotion contributes to human capital at all ages, advancing children’s attainment in school and working-age people’s productivity in the labour market. Investing in the health of older people allows them to remain in paid work or to otherwise contribute to society for longer.

To make this happen, you can count on our continuous support and collaboration.

Yours faithfully,

Caroline Costongs                                                      

Director

EuroHealthNet

 

 

[1] EuroHealthNet (2018). EuroHealthNet calls for new and improved approaches to financing for health promotion and health equity. Statement. https://eurohealthnet.eu/media/news-releases/eurohealthnet-calls-new-and-improved-approaches-financing-health-promotion-and

EuroHealthNet General Council Statement June 2018

EuroHealthNet General Council Statement June 2018

The EuroHealthNet General Council, meeting in Brussels 6-7 June 2018, notes:

  • Learning from the EuroHealthNet Policy Seminar “Smart Investments – Let’s talk prevention” held in Brussels on 5 June, including:
    • The need for shifts to health promotion and disease prevention;
    • How to ensure smart use of available funds;
    • How to set up innovative structures;
    • How to encourage funders to use powers for investment shifts;
  • Publications to date of European Commission proposals for a Multi-Annual Financial Framework for the EU 2021-27, including the proposed new ESF+ group of programmes and the Horizon Europe Programme;
  • Continuing discussion of proposals for the future roles and powers of the EU, including during European Parliament elections to be held 23-26 May 2019,
  • Progress on the European Pillar of Social Rights, including towards strengthening of the European Semester for economic and social policy coordination;
  • Adoption by the 71st World Health Assembly of the 13th multiannual General Programme of Work for WHO, in the context of UN Agenda 2030 and Sustainable Development Goals.

EuroHealthNet reiterates its concern that prioritisation and direct funding for health promotion, public health, disease prevention and social equity remain insufficient to successfully achieve all goals and objectives set globally, in the EU, at national and regional levels.

EuroHealthNet confirms that the future for health lies with effective health promotion and prevention of diseases, through community based services linking people and professionals to shape the conditions for health equity and wellbeing.

EuroHealthNet expresses regret that European Commission proposals for a future EU health programme 2021-7 (while suggesting benefits of integrated approaches within the ESF+ and Horizon Europe programmes) nevertheless :

  • include reductions of already modest funds and address insufficient explicit attention to health promotion; 
  • do not sufficiently address how growing levels of  non-communicable diseases and health inequalities  will be tackled;
  • do not sufficiently promote health and wellbeing in other proposed programmes impacting on health determinants, specifically proposals regarding the Common Agricultural Policy.

Therefore EuroHealthNet calls on the EU Council and Parliament to consider improvements to the MFF that fully implement the EU Treaty requirements to protect health in all policies, and to promote wellbeing, cohesion and equity. EuroHealthNet commends:

  • The inspirational examples set out at the seminar “Smart Investments – Let’s Talk Prevention” by implementers, innovators, legislators and practitioners; and calls for them to be applied and scaled up systematically where appropriate for health improvements at all levels;
  • Improvements to the European Semester towards better social and health policy tools and instruments with real potential impacts in Member States; and calls for health and social equity stakeholders and investors to actively engage with positive national programmes.
  • The REJUVENATE framework developed by the Executive Board, agreed by the EuroHealthNet General Council in 2017 as a contribution towards 21st century health promotion.

EuroHealthNet commits to mobilise the collective knowledge, skills and experience of its members to:

  • Help investment decision makers to become more health and equity literate through understanding evidence on the benefits, cost saving, and cost effectiveness of health promotion and disease prevention, by developing evidence based guidelines, impact assessments etc;
  • Help members, partners and health stakeholders become more financially literate and engage better with relevant funding and investment institutions, agencies and investors, building on legislative and other examples towards more timely and “bankable” initiatives including social and health impact bonds and other instruments;
  • Identify intermediaries and alliances to help develop suitable short, medium and long term proposals, projects and ways to bundle and scale up innovation, good and promising practices and useful infrastructures;
  • Help to overcome barriers of cross sectoral governance, stewardship and exclusion of key stakeholders by enabling, understanding multiple roles and shifts, building common metrics;

And generally contribute to:

  • The development of EU Programmes towards better funding and activity support for Health in all EU Policies and activities; and improve the implementation of commitments for wellbeing, social equity, health promotion and disease prevention within the EU Treaties;
  • Incorporating and stimulating transformative advances through innovative approaches and emerging digital technologies; while safeguarding the physical and mental wellbeing of people throughout the life course in the face of rapid changes and disruptions, for example by enhancing health literacy and addressing commercial determinants of health.
  • The universal achievement of aims, objectives, and targets within the UN agenda process and Sustainable Development Goals, including knowledge and capacity building to address targets on tackling incidence of non-communicable (chronic) diseases and inequalities.

The post-2020 MFF must invest in children and aim to end child poverty

Alliance for investing in Children image

More than 20 organisations within the EU Alliance for Investing in Children and the Child Rights Action Group (CRAG) urge the EU institutions and its Member States to invest in children and develop a future Multiannual Financial Framework (MFF) that works to end child poverty and promotes the social inclusion of all children in Europe.

The future of Europe depends on investing in children, in particular in children and families in vulnerable situations. The EU and its Member States need to act urgently to protect around 25 million children estimated to be living in or at risk of poverty or social exclusion.

 The EU Alliance for Investing in Children proposes the following recommendations to ensure that the next MFF invests in children:
Ending child poverty and social exclusion in Europe should be a clear and visible priority in the next MFF.

  • STRUCTURE AND SIZE: The size of the next MFF should be adequate to fight child poverty and ensure child well-being in Europe:
  • APPROACH: The next MFF should promote a life cycle approach to social investment and social protection:
  • SUPPORT THE NATIONAL LEVEL: The EU funds aiming at poverty reduction and social inclusion under the next MFF should encourage national poverty reduction strategies and action plans:
  • SIMPLIFICATION: The simplification of the rules of the future MFF should aim to further promote the engagement of stakeholders, including CSOs, and increase adequate funds absorption:

Call to action on Migration and health

EuroHealthNet has joined a call for better EU action on migrant health.

The joint paper calls for:

  1. A more holistic, human-centred approach to migration and health Implementation of a robust “health in all” policy, consistent with the EU’s treaty obligations, so that policies in other sectors do not undermine, and where possible support, Europe’s duty to safeguard the right to health, without discrimination.
  2. Specific and focused initiatives addressing discrimination as a determinant of health, such as funding for research on the impact of stigma and discrimination experienced by migrants and ethnic minorities on their health; and a commitment by European institutions to ending the use of dehumanizing language that refers to any person or form of migration and “illegal”.
  3. Concrete steps to mitigate the health-related effects of immigration control, such as integrating an explicit family perspective into immigration policy, enacting a clear policy against the detention of children and their families, and the development of guidelines to promote trust in public institutions and the health system by prohibiting the exchange of data for immigration control purposes.
  4. More and better data on and analysis of migrant and ethnic minority health to better understand and to address in a targeted way health inequalities experienced by migrants and ethnic minorities, and integration of migration status and ethnicity into measures of universal health coverage and social determinants.
  5. More focus on structural, rather than stop-gap, change to health systems that encourages the adoption of sustainable approaches, grounded in established rights, norms and evidence, and consider specific action to address maternal health, consistent with Sustainable Development Goals 3 and 5.

The associated framing document can be found here.(pdf)

The call and framing document have been developed by PICUM.

Consultation Responses

Why tobacco taxation matters for health equity

Tobacco consumption is the most significant cause of premature death in the EU and one that disproportionally affects our poorest and most disadvantaged citizens. Not only are rates of tobacco consumption higher amongst the lowest socio-economic groups, they suffer more from its effects.

EuroHealthNet has summarised it’s knowledge and position on tobacco taxation in a response to a European Commission’s consultation in August 2018. The full response can be found below.

Although the rate of tobacco use has declined, it has not declined enough nor equally amongst all groups. Much more remains to be done. Tobacco taxation is a very cost-effective public health prevention as revenues increase and smoking rates fall.

The use of novel tobacco products looks set to grow. National initiatives to research and regulate e-cigarettes and packaging are encouraging, but while the long – term effects of e-cigarette use remain unknown, caution should prevail. Clinician-led use of novel products can have a place in tobacco cessation services,  along with increased health literacy and health education as part of wider health promotion approach. However, unregulated and fully open markets can perpetuate the sale of harmful products, exploiting the vulnerability and inequalities experienced by certain groups

The EuroHealthNet partnership strongly supports the continued increase of excise duties and taxation on traditional tobacco products and the consistent excise treatment of e-cigarettes as an equivalent product to tobacco

In response to the consultation response, EuroHealthNet expresses:

  • Strong support for the further increase of tobacco taxes and the EU wide harmonisation of fiscal policy with regard to e-cigarettes, to bring their treatment into line with that of conventional tobacco products
  • Strong support for effective and comprehensive regulation at European level, including agreement on a common fiscal definition and the establishment of distinct category for e-cigarettes in EU excise legislation
  • Strong support for the adoption of an intelligent and contextual approach to regulation to mitigate the risk of e-cigarettes becoming a ‘gateway’ product to tobacco, particularly amongst those who are young and/or vulnerable
  • A cautious endorsement for the use of e-cigarettes as one element of properly planned and supervised smoking cessation programmes.

Consultation on the integration of the long - term unemployed into the labour market

In June 2018, EuroHealthNet replied to the European Commission's consultation on the integration of long - term unemployed into the labour market

EuroHealthNet urges EU institutions to address the imperative of addressing the health, social, economic and structural barriers linked to the (un-)employment, in particular of people with chronic diseases, to ensure that all people can meaningfully contribute to economies and societies . with special attention to quality work. It is also necessary to increasingly apply a structural approach recognising that EU goes beyond individual choice.

Response to inception impact assessment on the future Recommendation on Quality in Early Childhood Education and Care

EuroHealthNet submitted a response to the inception impact assessment on the future Recommendation on Quality in Early Childhood Education and Care, April 2018.

It also submitted a joint response as part of the alliance for investing in Children.

EuroHealthNet’s policy recommendations are:

  • The QECEC Recommendation should make a clear connection to health equity and wellbeing over the life course.
  • The QECEC Recommendation should promote the investment in early years to support good quality early years education and childcare provided in a proportionate way across the social gradient. Support for families should be improved by investing in pre- and post-natal interventions, encouraging parental leave, ensuring the income for a decent life, as well as through parenting programmes and children’s centres including outreach interventions to identify the most vulnerable and provide targeted support.
  • Use the European Regional Development Fund and European Social Fund to implement early child health and development interventions in areas of social deprivation.
  • Foster the implementation of the EC Recommendation on Investing in Children, which calls on MS to support parents into paid work and improve access to affordable early year’s childcare, education, and healthcare.
  • Connect the initiative to the EU Semester (Country Specific Recommendations, National Reform Programmes, and the Social Scoreboard – in the latter is it necessary to broaden the use of indicators to “children at the risk of poverty and social exclusion”).
  • Connect the initiative to the European Pillar of Social Rights (Principle 11: Childcare and Support to Children; the Social Scoreboard; the Work-Life Balance Directive).

Consultation on the next Multiannual Financial Framework (MFF)

EuroHealthNet has submitted three specific responses to the EU Public Consultation on the future EU revenue and expenditure priorities for 2021-27, known as the post 2020 MFF.

The three submitted questionnaire responses provide answers on EU funds in the area of:

  • Health, Research & Innovation in the Single Market;
  • Cohesion
  • Values & mobility

A short summary document of the responses and the three submmitted contributions can be downloaded by clicking on the links below.

Consultatons on vaccinations

In February 2018 EuroHealthNet responded to stakeholder and public consultations on vaccination.

The document below summarises EuroHealthNet’s response to the European Commission’s consultations on possible activities to be included in a proposal for a Council Recommendation on Strengthened Cooperation against Vaccine Preventable Diseases, which will be adopted mid-2018.

It addresses three aspects:

  1. Tackling vaccine hesitancy at national and EU level;
  2. Sustainable vaccine policies in the EU;
  3. EU coordination, including the promotion of stakeholder dialogue, and contribution to global health.

From a health equity perspective EuroHealthNet considers that priority should be given to addressing the needs and fulfilling the right to health of the underserved. This requires better commitment, investment and outreach programmes to tackle the under coverage of marginalised, migrant, or socially disadvantaged children and families. It is important to invest in health promotion and education programmes, and fight vaccine hesitancy by providing transparent and evidence-based information to the public in targeted and tailored ways.

2017

Statements

Joint Statement on Improving the Employment of People with Chronic Diseases in Europe

EuroHealthNet has signed a joint paper on issues relating to the employment of people with chronic diseases. The accompanying framing paper offers recommendations to EU and national policymakers to address the identified challenges, and urges the European Commission and EU Member States to include them in their actions to address chronic diseases as well as in strategies on social equity and on employment, jobs and growth.

The Post‐2020 MFF Must Invest in Children and Aim to End Child Poverty

EuroHealthNet and other members of the EU alliance for investing in children have urged the EU institutions and its Member States to invest in children and develop a future MFF that works to end child poverty and promotes the social inclusion of all children in Europe.

The joint statement explains:

‘The future of Europe depends on investing in children, in particular in children and families in vulnerable situations. The EU and its Member States need to act urgently to protect around 25 million children estimated to be living in or at risk of poverty or social exclusion.

Growing up in poverty can negatively affect children's opportunities for the rest of their lives, with far reaching consequences ‐ for instance, on their future education, health, participation in the labour market and society. Acting early on child poverty and investing in early childhood education and care is not only a moral imperative, it is also a cost‐effective measure.’

What is the future of Public Health Policy within the European Union?

As the commercial and political determinants of health become increasingly shaped at supra-national levels, there is a clear and pressing need and role for an EU that is actively and visibly at the forefront promoting improvement for the health of European citizen’ states EuroHealthNet President Nicoline Tamsma along with Natasha Azzopardi-Muscat, Katarzyna Czabanowska, and Archie Turnbull in an article for the European Journal of Public health by leaders of European health organisations. It looks at the impact of a changing Europe on public health policy, and what role public health could have in future European scenarios.

Statements to the 67th session of the WHO Regional Committee for Europe

The 67th session of the WHO Regional Committee for Europe, held in Budapest, Hungary, 11–14 September 2017 brought together the 53 Member States of the WHO European Region as well as partner organizations.

EuroHealthNet presented statements on ‘Roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020 -the European policy for health and well-being’ (agenda item 5a) as well as on the 'outcomes of the Sixth Ministerial Conference on Environment and Health' (agenda item 5b).

A written statement covering both agenda items (.pdf) stresses that a 'determinants approach' to health, is the best way to link public health and the sustainability agenda. It covers active mobilisation of other sectors, achieving a participatory society, guidance on the commercial determinants of health, and Strengthening public health and health promotion institutions 

Oral statements on Item 5a and 5b are also available.
 

The continued need for public health research in Europe

 EUPHA EuroHealthNet EPHA.png

On the 9th of June 2017, the EU’s Scientific Panel for Health is organising its second annual conference on: ‘Health research in a connected and participative society’. The European Public Health Association – EUPHA, EuroHealthNet and the European Public Health Alliance – EPHA, welcome this conference, and especially the priority it will give to participative and collaborative research. However, having read the programme, with its focus on health technology, digital innovation and health care, it risks missing an opportunity to promote research that could bring major benefits to the health of Europe’s citizens. Specifically, we are concerned that there is insufficient attention to public health research. Such research, seeking to develop population-level responses to the growing burden of diseases, and especially of multi-morbidity, can offer innovative means to prevent and protect health by tackling some of the major drivers of the overall burden of disease.

Read the full statement (pdf)

EU: Do More for Health

EU: Do More for Health

Health is absolutely and unequivocally a core business of the EU

EuroHealthNet is part of a campaign calling on the European Commission to step up coordinated EU action to tackle cross-border health challenges.

Visit the campaign page

Our letter to President Juncker:

Dear President Juncker,

We, the undersigned organisations, representing EU health stakeholders, wish to express our grave concern about the future of health in European policies and programmes, in the light of your White Paper on the Future of Europe, and propose an urgent meeting with you and your services on this topic.

Our determined view, shared by the vast majority of EU citizens, is that health is absolutely and unequivocally a core business of the EU. Protection of a high level of human health and wellbeing is entrenched in the Treaties of the European Union.1 EU collaboration in the field of health is indispensable for the future of Europe and rebuilding the trust of citizens in the European Union. We need more health to unlock the full potential of economic and social policies.

70% of Europeans want the EU to do more for health, according to the most recent Eurobarometer survey. With such a strong, unequivocal demand from EU citizens for more action in the field of health, it is essential that this is not only maintained, but actually enhanced. The EU needs to continue deliver results that make a tangible difference in the daily lives of its citizens and thus re-establish people’s trust in its institutions.

Health protection and improvement is a great success story of the European Union

View the PDF to read the full letter

Call and commitment for action to take REJUVENATE forward 2017 – 2020

REJUVENATE

The EuroHealthNet statement on Promoting Health and Well Being towards 2030 and the REJUVENATE Framework for Health Promotion was developed in 2016 in consultation with EuroHealthNet members and partners, and in preparation for the 9th Global Conference on Health Promotion.

The purpose of this call and commitment for action is to remind, encourage and strengthen the implementation of EuroHealthNet statement and Framework over the coming years.

The EuroHealthNet General Council, meeting in Helsinki on 1-2 June 2017, noting developments since its previous annual meeting in 2016:

A: at international and European levels, including:

  • The Shanghai Declaration on promoting health in the 2030 Agenda for Sustainable Development
  • The EC proposal for an EU Pillar of Social Rights;
  • The EC White Paper on the Future of the EU;
  • The WHO Europe Paris Conference on inter-sectoral actions for health and wellbeing;
  • The EU Communication on implementing the Sustainable Development Goals, and national voluntary reviews; The State of Health in the EU initiative

B: Key publications brought forward by EuroHealthNet, including:

  • Statement on health inequalities co-signed by 30 members of the EU Health Policy Forum
  • Position statements on the proposed EU Pillar of Social Rights;
  • The EuroHealthNet Annual Report 2016-2017
  • The INHERIT baseline evidence on moving, consuming and living in the EU;
  • The CHRODIS ’12 steps’ recommendations on tackling chronic diseases;

C: Key points from its seminar on “Tackling health inequalities in a fast changing world” at the General Council meeting in Helsinki, 31 May 2017

  • Health is a political choice; improving and sustaining it should be a high priority for the future of the EU. Joining forces across policies and sectors, sharing responsibilities, and mutually reinforcing efforts by collective investments and responsibilities are of utmost importance.
  • Health inequalities vary substantially between and within countries. Gaps must be closed by fairer allocation of resources, priorities and by taking advantage of the most effective, integrated health, employment and social systems and policies.
  • Innovation, the digital agenda and experiments must go hand in hand with equity and wellbeing objectives, and take account of developments in technology, employment and welfare investments.

1. CALLS ON policy makers, practitioners and researchers to also take forward, support, implement and improve the REJUVENATE framework and promote health in a rapidly changing world by:

  • SUSTAINABLE POLICY MAKING
  • BUILDING AND APPLYING NEW KNOWLEDGE
  • TRANSFORMING HEALTH SYSTEMS
  • IMPROVING WAYS IN WHICH WE WORK AND RESOURCES WE NEED

2. AND to join us in our commitment to take the ten REJUVENATE steps towards the 2030 agenda for health promotion and sustainable development by being:

  • Responsive: adapt to challenges and use new opportunities;
  • Equitable: address the causes of the causes;
  • Joined Up: build partnerships and governance across sectors;
  • Updated:  be proactive and smart to influence 21st century realities;
  • Value driven: develop values and rights for health in new contexts;
  • Ethical: apply and promote the fairest standards in all we do;
  • New: create and implement new ideas;
  • Active: practice inclusive engagement;
  • Technological: understand and apply technical and digital advances;
  • Ecological: sustain and protect our environments

3. COMMITS to help to take forward, lead and support efforts towards sustainable health equity and wellbeing by:

  • Stepping up our efforts to tackling the determinants of health and inequities.
  • Applying a life-course approach, to leave no one behind, also acknowledging that disadvantages accumulate over life and a good start in life is key.
  • Supporting healthy places, environments and communities;
  • Involving new allies at all levels and develop partnerships.
  • Strengthening health promoting systems, and ensuring that health systems are equitable.
  • Strengthening public health and health promotion research, innovation and evaluation, also promoting the use of evidence, information and research for policy and practice.

EuroHealthNet will monitor and review progress through its Executive Board and evaluations at its annual General Council Meetings.   --  Helsinki, June 2 2017.

 

European networks’ response to the Staff Working Document taking stock of the implementation of the 2013 Recommendation on ‘Investing in Children: breaking the cycle of disadvantage’

European networks’ response to the Staff Working Document taking stock of the implementation of the 2013 Recommendation on ‘Investing in Children: breaking the cycle of disadvantage’

Analysing the European Commission’s staff working document taking stock of the implementation of the Recommendation on ‘Investing in children: breaking the cycle of disadvantage’,[1] many of the partner organisations of the EU Alliance for Investing in Children are pleased to see that the document recognises the crucial role played by civil society, and by the EU Alliance in particular as key stakeholders.

The document provides an honest overview of the current implementation status of the Recommendation at EU and Member States level. It reiterates the message that investing in children is not only an ethical imperative, but also cost-effective for society as a whole. We commend that the document reflects the holistic, three-pillar approach of the Recommendation and mentions the specific situation of particularly disadvantaged groups of children (single-parent and large families, Roma children, children with disabilities, children in alternative care, homeless children, children in migration). We also share the Commission’s belief that EU funding – also in the post 2020 financial framework – is crucial for the delivery of the Recommendation. However, we regret that the document does not include a roadmap for the implementation of the Recommendation. We believe that establishing a visible communicable plan with specific objectives and key milestones, would have been an extremely helpful tool.

The staff-working document recognises the essential role that the European Semester plays in monitoring national child and family policies, however we strongly believe further action is needed to ensure that children’s rights and family support are at the heart of the Semester cycle.

The package launched by the European Commission on 26 April urges Europe to rebalance its social and economic priorities. We welcome the reference to child poverty within the European Pillar of Social Rights, however, we are concerned that it is still unclear how it will contribute to the implementation of the Investing in Children Recommendation, especially as the latter is addressed to all EU Member States and not just to the Eurozone countries. Furthermore, we believe indicators in the new Social Scoreboard should be aligned to monitor progress on the implementation of the Recommendation.

While we would have expected the document to include a more forward-looking perspective, we assess the staff working document as a good starting point to develop further actions to be taken, both at national and EU level, and to foster the implementation of the Recommendation. Our European networks and our national members look forward to working with EU institutions and the national authorities to further this specific agenda.

Notes to the editors:

The EU Alliance for Investing in Children has been advocating for a multidimensional, rights-based approach to tackling child poverty and promoting child well-being since 2014.

This statement was endorsed by the following partner organisations of the EU Alliance for Investing in Children: Caritas Europa, COFACE Families Europe, Don Bosco International, European Anti-Poverty Network (EAPN), EASPD European Association of Service Providers for Persons with Disabilities (EASPD), Eurochild, Eurodiaconia, EuroHealthNet, European Federation of National Organisations Working with the Homeless (FEANTSA), European Parents’ Association (EPA), Mental Health Europe, Platform for International Cooperation on Undocumented Migrants (PICUM), Save the Children, SOS Children’s Villages International.

[1] The Recommendation on ‘Investing in children: breaking the cycle of disadvantage’ was adopted by the European Commission in February 2013.

Joint statement about young people’s social inclusion on the occasion of the Annual Convention on Inclusive Growth (ACIG) 2017

This year, the Annual Convention focusses on young people’s social inclusion and on good practices to respond to their complex needs. Today, we highlight several important aspects for the development of European youth policy and practice:

  • Develop integrated services for vulnerable young people: Young people are a diverse group, among them are young people in public care, young carers, unaccompanied migrant children, young people with mental health problems or disabilities, and early school leavers. They often find themselves in challenging life circumstances that require integrated support from different professionals, be that social workers, teachers, carers, mental health professionals, or job coaches.
  • Respond to the needs of young carers across Europe: Young carers are children and young adults who provide care for a parent or relative in the community, usually within their own home. They can perform the most personal and intimate of tasks, often without any help or support from welfare agencies. Many young carers provide care at great personal expense - they are deprived of their childhood, few have established friendships or other support networks. Young carers are at greater risk of not completing their formal education and are less able to enter into higher education reducing their life chances and increasing their social exclusion.
  • Address the causes of ill health and the barriers to well-being: Poor mental and physical health, and the unhealthy environments and behaviours which cause them, can block young people from the labour market. Subsequent financial and social exclusion leads to further ill health, leading to a viscous cycle and long-term negative impacts. To effectively address these challenges and build resilient labour markets, we need to tackle risks for ill health and barriers to well-being. Support should focus on the needs of the most vulnerable, as they are most affected.

This is a shared statement signed by three different European networks about young people’s social inclusion and complements the jointly prepared ACIG session on “Barriers and success factors to facilitate young people’s social and labour market participation”.

The EUROPEAN SOCIAL NETWORK is the network for local public social services

EUROHEALTHNET is a partnership of organisations, agencies and statutory bodies working to improve health, equity, and wellbeing.

EUROCARERS is the network representing informal carers and their organisations

John Halloran           

Caroline Costongs

Stecy Yghemonos

The Europe we want: Just, Sustainable, Democratic and Inclusive

As we mark the 60th anniversary of the Treaty of Rome, we have a momentous opportunity to take stock of how far Europe has come – and how far we still have to go in order to offer a sustainable and prosperous future to everyone in Europe. It is an opportunity that we call on you, the leaders of Europe, to seize with both hands. We call on you to show leadership, vision and courage to set Europe on the path to a sustainable future which realises the rights of all people and respects planetary boundaries.

In March 2017 EuroHealthNet joined this Common appeal to European leaders by European Civil Society Organisations and Trade Unions

Call for actions for health and equity

Noting the high levels of health inequalities in many EU countries, 30 EU health organisations call on European Institutions and Member State governments to recognise the central role that health and health equity play in building strong and sustainable social market economies.

We also urge European Institutions and EU Member States to put health inequalities at the forefront of their health related priorities, as a topic in and of itself, and to place a stronger emphasis on health equity as an indicator, not only of how health systems are performing, but of how well Member States and the EU are delivering well-being for their people.

This Joint Statement was developed by EuroHealthNet in collaboration with a number of organisations that are part of the EU Health Policy Platform and which have endorsed the Statement. Its purpose is to send a strong message from health organisations across the EU of the urgent need for action on health equity, taken within and beyond health systems, to ensure the well-being of all EU citizens.

On the proposal by the European Commission to establish an European Pillar of Social Rights (EPSR).

This Position is the overall view of EuroHealthNet, regarding the announcement in 2016 that the European Commission is considering establishment of a “European Pillar of Social Rights (EPSR)”. The Position has been adopted by the EuroHealthNet Executive Board.

It is published for the attention of EU Institutions, other international organisations and a wide range of relevant stakeholders at international, national and sub national levels, to help inform them of the relevance and importance of health, equity and wellbeing in this potential development, and to raise awareness for all interested citizens and bodies on the opportunities and challenges this initiative presents.

In addition to this overall Position, EuroHealthNet will also submit and publish its specific evidence based Response related to health and social equity to the online EC Public Consultation in advance of the deadline in December 2016.

Furthermore, EuroHealthNet is engaged in dialogues as part of wider public consultation in Member States and at international levels, for example via the EU Public Health Policy Forum and Platform.

Subsequently, EuroHealthNet will contribute to public and EU Institutional debates on the anticipated “proposal” and “related initiatives” announced by the EC in its 2017 Work Programme.

Consultation Responses

Consultation on health and care in the digital single market

EuroHealthNet responded to the public consultation on transformation of health and care in the
digital single market

Communication on Digital transformation of health and care in the context of the Digital Single Market

EuroHealthNet welcomes the consultation towards a Roadmap for the EC Communication on this subject. The collaboration between DGs CONNECT and SANTE is particularly important; however this should be extended to ensure cohesion with other relevant DGs and EU
instruments such as the EU Semester processes and the potential EU Pillar of Social Rights. Mention of the need to address health inequalities is welcome; however this is potentially both a key positive and negative factor and should be more prominent. Since the 2009 Communication Solidarity in Health it is increasingly recognised that health inequalities cost EU governments significantly: they reduce people’s ability to contribute to society, undermine economic growth and prosperity, and increase health, social care and wider public expenditures.

Digital technologies do offer new opportunities to transform health care systems, including new approaches to personalised prevention, treatments and care, independent living, integrated health and social care, accelerated scientific progress for early diagnosis and prevention of diseases. However, there are significant risks and obstacles of inequitable implementation including safety, access, effectiveness and authority.

Consultation on EU urban agenda

EuroHealthNet responded to the consultation on the EU urban agena in relation to air quality, inclusion of migrants & refugees, and urban poverty.

Modernising and Simplifying the Common Agricultural Policy (CAP)

EuroHealthNet responded to the EU survey Modernising and Simplifying the Common Agricultural Policy (CAP)

mid-term evaluation of the European Union Programme for Employment and Social Innovation (EaSI)

EuroHealthNet responded to the mid-term evaluation of the European Union Programme for Employment and Social Innovation (EaSI)

Public Consultation for the Evaluation of the EU Agencies: EUROFOUND, CEDEFOP, ETF and EUOSHA

EuroHealthNet responded to the Public Consultation for the Evaluation of the EU Agencies: EUROFOUND, CEDEFOP, ETF and EUOSHA

Public Consultation on the European Solidarity Corps

EuroHealthNet responded to the Public Consultation on the European Solidarity Corps

Tobacco Excise

EuroHealthNet responded to the Public consultation  on Excise duties applied to manufactured tobacco

Evaluation of the long-term unemployed recommendation

This feedback builds upon the impact long term unemployment (LTU) has on health inequalities (HI). HI cost EU governments significantly: they reduce people’s ability to contribute to society, undermine economic growth and prosperity, and increase health, social care and wider public expenditures.

The link between unemployment and ill health is well established. Unemployment has a higher negative on health for people from low socio-economic groups. Unsurprisingly, LTU sees effects on ill health compounded: people experience negative pressures on their physical
and mental health.

Mid-term evaluation of the Third Health Programme

EuroHealthNet contributed to the consultation on the Mid-term evaluation of the Third Health Programme (2014-2020)

Consultation on Digital Health Societies

Digital health is a potential set of tools and instruments within processes to tackle inequities. Digital health offers the advantage of increasing access to disadvantaged populations. However this is not only about access to services, but also an opportunity for empowerment, balancing collective rights (to organise systems for States, Authorities and providers) with individual rights (rights to care, treatment, protection and prevention as set out in the EU Treaty, Charter of Fundamental Rights and potential EU Pillar of Social Rights).

In that context digitalisation of health and care systems could be a key trigger for removing health inequalities, as foreseen in the 2009 EU Communication Solidarity in Health; in the UN Agenda 2030 and Sustainable Development Goals (SDGs) and in the evidence and recommendations of the WHO Commission for Social Determinants of Health (SDH).

EuroHealthNet, the European Partnership for sustainable health promotion, wellbeing and social equity, has identified technological changes as one of the ten greatest priorities to be embraced and applied by public health and health promotion sectors towards 2030 objectives. EuroHealthNet is working with its national and regional members, EU Institutions and WHO Europe on sustainable health systems, health information systems, data use, health determinants and health literacy.

2016

Consultation Responses

Consultation on Evaluation of the Youth policy cooperation in the EU

EuroHealthNet responded to the public consultation on evaluation of the Youth policy cooperation in the EU

Possible action to address the challenges of work-life balance faced by working parents and caregivers

EuroHealthNet responded to the EU survey on possible action to address the challenges of work-life balance faced by working parents and caregivers

Consultation on the Energy Union

EuroHealthNet responded to the public consultation on the development of a comprehensive, integrated Research, Innovation, and Competitiveness Strategy for the Energy Union.

On the proposal by the European Commission to establish a potential European Pillar of Social Rights (EPSR)

EuroHealthNet has conditionally welcomed the European Commission (EC) initiative to establish a “European Pillar of Social Rights”. Announcing its overall position after a substantial consultation with members and partners in EU Member States, EuroHealthNet sees the Pillar as an opportunity to clarify unclear objectives and provisions in the EU Treaties and body of laws concerning equality, wellbeing and social determinants of health. EuroHeathNet has made concrete proposals for the implementation of the initiative.

EuroHealthNet warns against risks of increasing inequalities if Eurozone states are treated differently from others, but insists “There can be no EU without a social EU”. Its members feel that many health and social responsibilities should remain with States and sub-national authorities, but there is scope for improvements in existing legislation, plus some important new initiatives.

In particular, EuroHealthNet calls for numerous actions and investment directly related to social and economic factors causing ill-health, plus several innovative ideas for content of the potential Pillar:

  • An EC Vice President with responsibility to ensure implementation of social measures;
  • A new Directive on Social Sustainability using models in development in Sweden and elsewhere;
  • Improved measures to support States address health and social issues in the EU Semester;
  • Alignment of goals and targets with the global 2030 Sustainable Development commitments

Better Research for Better Health: EuroHealthNet's comments and recommendations

EuroHealthNet has been invited to respond in writing to a consultation on the European Commission's Scientific Panel for Health (SPH) Vision paper Better research for better health. The paper presents key recommendations for health and biomedical research under the Horizon 2020 Framework Programme.

While acknowledging that the paper presents some interesting points, EuroHealthNet fears that the paper’s approach is almost exclusively from a biomedical point of view, and calls for a more holistic approach.

Through the consultation’s response, EuroHealthNet highlights how to achieve health and well-being for all the issue should be seen from a wider perspective that considers social and environmental determinants as having as much impact on health as biological and genetic factors.

To access the response from EuroHealthNet, click here.

Statements

3 Steps Towards Healthier Marketing

 

 

 

Europe faces a childhood obesity epidemic: up to a third of 11-year-olds is overweight or obese.1 Youth binge drinking is widespread and causes major harm, while nearly half the European youth used alcohol before the age of 13.2 Health problems starting in childhood often last a lifetime.

It is well-established that advertising causes changes in consumption patterns favouring the products advertised.3 Nevertheless, children and young people in Europe are still daily subjected to the aggressive marketing of alcohol and foods high in fat, sugar and salt (HFSS).

The current revision of the Audiovisual Media Services Directive (AVMSD) is the opportunity to free Europe’s children and youth from health-harmful marketing. Undersigned organisations call on Members of the European Parliament to grasp this opportunity and improve the Directive.

A new Europe for people, planet and prosperity for all

Europe is at a crossroads, and the future of European cooperation and the benefits it brings are at stake. This is about the future of our society and how we want to be viewed by the wider world. The future of our planet and the kind of Europe our children will grow up in. The current crisis highlights the urgent need to reflect on fundamental questions: how do we ensure that the European project reclaims its promise of peace, democracy and solidarity? How can Europe work for its people?

Too many people across Europe are dissatisfied and disillusioned with the European Union and feel remote from its institutions and policies. But there are groups of committed politicians, trade unions, community groups and non-governmental organisations across Europe who are ready to take action and work for a renewed Europe. Together, we can shape a Europe that is inclusive, open, just, sustainable, and that works for people of all ages, social backgrounds and nations.

Where do we go from here to build the Europe we want and need?

2015

Consultation Responses

Consultation Response to the public consultation on long-term unemployment

While responding to this consultation, EuroHealthNet highlighted some of the most relevant evidence-based practices and findings of its FP7 DRIVERS project. Involving prominent research centres and public health, civil society and business organisations, DRIVERS’ goal was to find solutions to improve health equity through policy and practice in (among other areas of focus) fair employment, income and social protection.

This consultation response is an evidenced-based contribution resulting from EuroHealthNet’s FP7-funded DRIVERS project focused on links and best ways to tackle equity through policy in, amongst others, employment and working conditions.

To access the response from EuroHealthNet, click here.

2014

Consultation Responses

EuroHealthNet's response to public consultation on the Europe 2020 strategy

The Europe 2020 strategy was launched in March 2010 as the EU's strategy for promoting smart, sustainable and inclusive growth. It aims to achieve a knowledge-based, competitive European economy while preserving the EU's social market economy model and improving resource efficiency. It was thus conceived as a partnership between the EU and its Member States driven by the promotion of growth and jobs.

After four years, the Commission has proposed, and the European Council of 20-21 March 2014 has agreed, to initiate a review of the Europe 2020 strategy. On 5 March 2014, the Commission adopted a Communication "Taking stock of the Europe 2020 strategy for smart, sustainable and inclusive growth". drawing preliminary lessons on the first years of implementation of the strategy. Building on these first outcomes and in a context of a gradual recovery of the European economies, it is time to reflect on the design of the strategy for the coming years.

Through these questions, EuroHealthNet, its members and its partners suggest how health and systems can become part of the solution for Europe's ills rather than bes seen as part of the problem. 

Read EuroHealthNet's response to the public consultation on the Europe 2020 stragey here

EuroHealthNet response to the European Commission’s public consultation on the Green paper on mobile Health (mHealth)

Mobile Health (mHealth) is a relevant topic for EuroHealthNet as it bears great potential for novel means of health promotion, disease prevention and healthcare. The use of mobile and wireless technologies can support achievement of various health objectives.

However, EuroHealthNet wants to highlight that there are various aspects that have to be taken into consideration when designing and implementing mHealth solutions. One is that there are different levels of knowledge, skills and capabilities within the social groups, which play an important role in understanding new technologies and the messages it delivers. If they are ignored then mHealth promotion activities and mHealth treatment and monitoring will widen inequalities and create an even bigger health gap between advantaged and disadvantaged groups in society. It is therefore crucial to ensure that the design and application of mHealth is tailored accordingly to the needs and skills of different (social) groups, and that the merits of health technology benefit the whole society.

EuroHealthNet responds to the consultation by focusing and commenting particularly on the questions that are most relevant to health promotion and disease prevention from the social and health equity perspective.